Diabetics frustrated with changes to Medicare

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LAWRENCE, Kan. --This month, Medicare made a change aimed at saving taxpayers billions of dollars. But community pharmacists say it could wind up putting patients at risk and result in more waste.

Nancy Porter is well enough to come to Sigler Pharmacy in Lawrence to get her diabetic testing supplies. But there have been times when she's recovering from hospital stays and needed the supplies delivered to her home.

"I could call up and just ask Jeff to bring 'em out that day," Nancy said.

But she says not anymore. Not if Medicare is going to cover them. As of July 1, Medicare said all home delivery of diabetic testing supplies must be done by 18 companies that do mail order delivery.

"They're just arbitrarily providing more business to 18 companies versus 20,000 independent pharmacies," pharmacist Jeff Sigler said.

Medicare said those 18 won in a competitive bidding process aimed at reducing fraud and excessive costs. Under the previous Medicare program, a hundred test strips and lancets cost nearly 78 dollars. Now they are 22 dollars. That means savings for Medicare patients, too, since they pick up 20 percent of the cost.

But Sigler said maybe there won't be that much savings. He points to a photo he took of all the supplies that the relatives of one patient brought to him after her death. They were supplies from a mail order pharmacy that were never used. He said hometown pharmacists are better able to monitor use and prevent waste.

Nancy wonders if elderly, homebound patients will just stop doing testing to avoid dealing with the mail order companies.

"They can't figure out how to get 'em ordered," she said.

And without testing, the pharmacist said there would be poorer outcomes for people with diabetes.

But Medicare says in its pilot program which included Kansas City, follow-up indicated that access to supplies has been preserved, and there were no signs of more emergency visits or hospital stays.

Medicare patients can still pick up their diabetic testing supplies at their hometown pharmacy. That's if the pharmacy agrees to the lower Medicare payment.

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