Impact of Medicare changes in pharmacy reimbursement on patient care: two case reports.

ABSTRACT

PURPOSE: Two case reports illustrate the impact of changes in pharmacy reimbursement associated with the Medicare Prescription Drug Improvement and Modernization Act (MMA) on patient care. SUMMARY: The Medicare Part D benefit is complex and difficult for patients to understand. A patient's personal financial situation and quality of life issues may enter into decisions about enrolling in Part D and the use of drug therapy. Local coverage decisions by the Centers for Medicare and Medicaid Services can limit access to drug therapy and raise ethical dilemmas. CONCLUSION: Changes in pharmacy reimbursement associated with MMA has the potential to markedly impact patient care and outcomes.