With the government now the largest purchaser of drugs, pharma companies and advocacy groups are uniting to educate beneficiaries. Beth Herskovits discovers how this helps all parties
At senior centers around the country, trained Medicare counselors are guiding beneficiaries through the technology-driven process of choosing a drug plan. The counselors tour the US in green and white vans, hitting more than two-dozen states, and answering questions ranging from how to sign up, to which plan has the best coverage.
"It's like a political campaign in its intricacy," says Scott Parkin, VP of communications at the National Council on the Aging (NCOA). "It is a very intense [outreach effort], but very one-on-one talking to people."
The effort, dubbed "My Medicare Matters," is sponsored by a grant from pharma giant AstraZeneca. The company has found that the enrollment events provide an opportunity to speak about its commitment to Part D of the Medicare Modernization Act, the largest overhaul of the program in 40 years.
Part D, perhaps the most controversial section of the 2003 law, guarantees prescription drug coverage for beneficiaries.
Although the government and private health insurers (which offer the plan) have been heavily involved in the education and enrollment effort, no healthcare sector has stood idle - particularly the pharma industry.
"We're doing so much in terms of education and outreach," says Andy Izquierdo, senior federal government PR manager at AstraZeneca. "We want to make the transition as smooth as possible."
Some seniors, he notes, aren't even aware that the benefit has gone into effect. "Clearly, there are questions seniors [will] have," he says, adding that the outreach effort is focused on making seniors aware of their choices, not promoting one plan over another.
The My Medicare Matters campaign has combined media relations with grassroots events.
"Each team in each community works a little differently," says Eve Dryer, president of agency Vox Medica, which is leading the PR effort for My Medicare Matters. "One of our platform messages is reaching people where they 'work, pray, and play.'"
Parkin says the program grew out of a Pathways to Success report from the Access to Benefits Coalition, an advocacy group for low-income beneficiaries.
"One lesson learned is that one-on-one counseling is necessary in order to help them understand this [program]," he says. "AstraZeneca ... read that report and said, 'We want to do something to help.' They're as interested as we are, especially to reaching out to low-income seniors."
The Centers for Medicare and Medicaid has promised beneficiaries a choice of at least two plans in each region. But more choice has meant more confusion.
"There's a risk that the apparent complexity [of the enrollment process] will deter seniors from taking advantage of the plan," says J. Peter Segall, GM and head of Edelman's health, policy, and public affairs practice. "No company wants to see a person who needs its products not have drugs. Pharma companies are natural DTC communicators; they do that very well."
Drug companies also have a stake in the program's outcome. The industry is facing a new reality where the government is the largest drug buyer, and will decide which medications are covered on Medicare-approved formularies.
"The direct communications of what drugs get on formularies is a regulatory question, not a legislative one," says Michael Kuczkowski, an SVP at Edelman. "[But legislators must] feel like this program is working and pharma companies are negotiating fairly."
The program's success might also further drug companies' trust-building initiatives. If Medicare Part D helps overcome some of the cost and access barriers for seniors, there's reason to believe the industry will see an improvement in its reputation.
"The cost items that are most visible to [seniors] are the cost of medicines," says Segall. "Once we get past the early stage of implementation, there will be many more happy seniors than affected seniors. That's a very important message to get across."
Seniors who don't struggle to pay for their medications are less likely to press their legislators on issues such as drug importation, he adds.
But while drug companies - and their trade group PhRMA - are adding financial support to the enrollment effort, most are staying behind the scenes in terms of message delivery, instead relying on agencies such as the NCOA or coalitions like Medicare Today to educate beneficiaries.
Many of the industry's previous trust-building efforts have been rooted in developing the support of third-party partners and stressing risk communication. Medicare outreach is no different.
"It's been an opportunity for a partnership with government and third-party organizations," Dryer says. In addition, as more people take a company's drugs, "they actually have an expanded responsibility to ensure the appropriate and safe use of medicines."
Dealing with critics
Yet even as the drug industry has been funding many of the government's education efforts, it is also dodging criticism about changes to patient-assistance programs. Many companies have curtailed programs, citing anti-fraud laws that prohibit offering patients incentives to choose their drugs.
Instead, drug companies are trying to help seniors transition from discount cards to a Medicare-approved drug plan. Izquierdo says the drug plans will allow seniors - who might be enrolled in multiple patient assistance programs - to get all of their medications covered under a single program.
"I've seen articles that make it seem like... pharma companies are abandoning their commitment. That's unfair," Segall says. "It's an example of when a prevailing bias plays against a company... [that is] trying to do the right thing."
Medicare Part D - by the numbers
24 million +
Beneficiaries who've already enrolled in a drug plan
$25 Average monthly
premiums for drug plans-one-third less than expected
May 15 Deadline for
beneficiaries to enroll for 2006 coverage
Hundreds of thousands
Beneficiaries who enroll in a plan daily
Beneficiaries the government aims to enroll in 2006
Beginning of the 2007 enrollment period
polled pre-enrollment who said they understood the benefit "not too well" or "not at all"
(Sources: CMS one-month progress report, Kaiser Family Foundation)