Have you heard complaints that prescriptions for metoprolol succinate ER, one of the generic versions of the beta blocker medication Toprol XL, can’t be filled due to a national shortage of the drugs? Since late last year, our country’s two biggest suppliers of this commonly used generic high blood pressure medication have slowed production to almost a halt. Novartis’s generics unit, Sandoz, recalled 6 million bottles of generic Toprol XL late last year, after the FDA sent the company a warning letter about the factory in North Carolina that makes the pills. Another supplier, KV Pharmaceutical, is experiencing economic challenges and has said it would stop making and selling all of its products, including generic Toprol XL.
Most Medicare Part D plans cover the generic version of this drug, which is cheaper for beneficiaries to use. Now, however, when local pharmacies are unable to refill prescriptions for the generic version, they call the beneficiaries’ doctors to change the prescriptions. If the prescription is changed to the brand name, the drug is either on a higher cost-sharing tier or it’s not on the formulary at all.
Advocates are receiving complaints from beneficiaries about:
- having to pay more money for the brand name version of the beta blocker;
- not having enough money to pay for the brand name drug; or
- having to file an appeal to receive a version of this drug that’s not on their plan formulary.
Advocates have asked the Centers for Medicare and Medicaid Services (CMS) to issue plan guidance requiring them to cover the brand name version of the beta blocker until the shortage is resolved. CMS is currently following up on the drug shortage status. In the meantime, if you have any additional beneficiary/client complaints, stories or experiences around this issue, please share them with us and we will forward your complaints to CMS.
Here’s an article in the Wall Street Journal discussing the cause of the shortage.
For more information on Part D and/or appeals, see: