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Page: << Prev | 1 | 2 | 3 | Next >> The good news was that, in the vast majority of cases, patients could expect to find at least one drug from each of the eight classes that would be covered by their plan, with the exception of heart drugs called angiotensin II receptor blockers.
The real problem came in figuring out -- in the short amount of time allowed by most doctor's office visits -- whether a particular drug was or was not covered by a patient's participating health plan.
"In California, for example, we looked at people who were potentially faced with over 70 plans" to sort through, Tseng said. "That means that you'd have to have hard copies [of each plan's formulary] and look that up each time, or have Internet access and navigate through the Medicare Web site."
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Unfortunately, the study found that, in most doctor-patient encounters, that's just not happening. "This information is not currently easily available to physicians, and physicians don't have the time to look up every drug for every patient," Tseng said.
There were some helpful -- but not foolproof -- rules of thumb, however, the study found. For example, about three-quarters (73 percent) of generic drugs were widely available across plans. "So, physicians might think 'Great, that gives me a shortcut -- just prescribe the generic,' " Tseng said.
However, since one-quarter of generic medications aren't widely covered by plans, that could leave a large minority of patients frustrated as they run into roadblocks at their local drug store.
And those frustrations aren't just an inconvenience, Tseng said.
"These things have real consequences for patients," she noted. In fact, 17 percent of doctors who said their patients had failed to get a prescription filled explained that those bureaucratic mix-ups had led to "a serious medical consequence" for the patient involved.
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