Prescriptions go unfilled as Medicare D sees rocky start

Doctors and pharmacists are overwhelmed by technical and bureaucratic problems in the opening days of the Medicare drug benefit.

By David Glendinning, AMNews staff. Feb. 6, 2006.

Washington -- Robert E. Sager, MD, last month wrote some of his senior patients prescriptions they could fill using the new Medicare drug benefit, but several came back empty-handed.

The multitude of problems that have accompanied the Jan. 1 launch of Medicare Part D has affected the small town of Liberal, Kan., where Dr. Sager runs a solo family practice. Technical glitches and breakdowns in communication erased any hope that the start of the drug benefit would be a smooth affair, he said.

"The patients are finding that they're not in the computer yet, so the pharmacy won't give them the drugs because it can't get paid," he said. "The two pharmacies that operate here are both fed up with the paperwork, and they can't get through on the phones with the insurance companies to clarify anything."

As a result, some seniors and people with disabilities who couldn't afford to buy their medications without help found themselves at odds with the private insurance plans that the government entrusted to administer the benefit. A number of them gave up and went home before they resolved the situation.

Unfortunately for physicians, pharmacists and Medicare patients across the nation, Dr. Sager's story is not unique. Federal health officials said that tens of thousands of drug plan enrollees reported difficulties filling their first prescriptions under the new benefit during the first two weeks of operation.

If chronically ill patients begin to fall off their required drug regimens because of the problems, doctors worry they soon will start to see adverse health effects. Diabetics, patients with heart conditions and people with mental illness are at particular risk for serious health consequences, they said.