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

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.