Press ReleasesBLOG POST: MA provides big savings for seniors while rising drug prices present challenge

Medicare Advantage beneficiaries spend $1,965 less annually on out-of-pocket costs and premiums than those in original Medicare, according to a Better Medicare Alliance analysis conducted by ATI Advisory.¹

The report is based on Medicare Current Beneficiary Survey data from 2019, the most recent year available, and found a $325 increase in consumer savings compared with the previous year’s report.

These savings are seen across race and ethnicity, with Black MA beneficiaries spending $1,104 less on total health costs compared with original Medicare beneficiaries, while Latino MA beneficiaries save an average of $1,421.¹

The analysis comes amid significant concerns about seniors’ out-of-pocket costs, as reported in a Kaiser Family Foundation poll.² It also comes on the heels of a new study showing many original Medicare beneficiaries who don’t qualify for low-income subsidies don’t fill their prescriptions for expensive specialty drugs to treat serious health conditions.³

In 2021, more than 70% of Medicare Part D beneficiaries did not qualify for low-income subsidies and:

• 30% of patients without subsidies did not fill prescriptions for cancer drugs
• 22% didn’t fill prescriptions for hepatitis C treatments
• more than 50% didn’t fill medications for immune disorders.

According to HHS data, 3.5 million adults aged 65 or older, particularly Black and Latino adults, face challenges in affording medications.⁴

And even as older Americans are already struggling, prescription drug costs have increased 2.5% since the beginning of the COVID-19 pandemic.⁵ Prices for brand name drugs are rising faster than the rate of inflation, which has led many patients to not take their prescribed medications. This can lead to the need for even costlier interventions for both plans and members down the line, and can potentially affect health outcomes.

Rising drug costs are also a concern for the Medicare program itself. A new report shows blood thinners Eliquis and Xarelto have cost Medicare Part D $46 billion since 2015, and their prices have more than doubled since they entered the market.⁵

As drug prices continue to increase, MA plans are an attractive option for beneficiaries who hope to save money and have access to the best possible care.

“The path to meaningfully addressing Americans’ concerns about out-of-pocket costs and health care affordability and access for our nation’s seniors leads us to Medicare Advantage,” said Mary Beth Donahue, President and CEO of the Better Medicare Alliance.

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^References

1. Study: Medicare Advantage Saves Seniors Nearly $2,000 a Year Compared to FFS Medicare. Better Medicare Alliance. April 19, 2022. https://bettermedicarealliance.org/news/study-medicare-advantage-saves-seniors-nearly-2000-a-year-compared-to-ffs-medicare/
2. Kirzinger, A., Kearney, A., Quasem, M. KFF Health Tracking Poll – March 2022: Economic Concerns and Health Policy, The ACA, and Views of Long-term Care Facilities. KFF. March 31, 2022. https://www.kff.org/health-costs/poll-finding/kff-health-tracking-poll-march-2022/
3. Bean, M. Many Medicare patients don’t fill prescriptions for specialty drugs, study finds. Beckers. April 7, 2022. https://www.beckershospitalreview.com/pharmacy/many-medicare-patients-don-t-fill-prescriptions-for-specialty-drugs-study-finds.html
4. Tarazi, W., Finegold, K., Sheingold, S., et al. Prescription Drug Affordability among Medicare Beneficiaries. HHS. Office of Health Policy. Jan. 19, 2022. https://aspe.hhs.gov/sites/default/files/documents/1e2879846aa54939c56efeec9c6f96f0/prescription-drug-affordability.pdf
5. Lagasse, J. Price of two expensive drugs has cost Medicare Part D $46 billion since 2015. Healthcare Finance. April 7, 2022. https://www.healthcarefinancenews.com/news/price-two-expensive-drugs-has-cost-medicare-part-d-46-billion-2015