dr. woerner has a unique perspective on medicare part d. jack hoadley, dr. n. recently, dr. hoadley has studied various aspects of medicare part d, including the spending trends in use of formularies. dr. hoadley was also recently appointed to a three-year term as a member of the medicare payment advisory commission. and richard smith, executive vice president for policy and research at pharmaceutical research and manufacturers association. mr. smith has worked extensively in health care. and robert romasco, he is the president of aarp. and so, this is a distinguished and all. and because senator wyden i said we are going to forgo the opening statements since we have a though coming out then we look at right with the witnesses. so dr. woerner, we will start off with you. your full statement will be placed in the record. and if you all could give us about a five summary, we'd appreciate it. thank you so much. i hammack >> and i've been a hotline volunteer for the past eight years at the medicare rights center in new york city. the medicare rights center is a n

dr. hoadley quickly? >> with the comments i heard of affordability and we need to know more about what the plans are doing and we're starting to put that record together also cms includes with the star ratings systems it could be a tool with the ability to do this also the consumer could say it has a better track record and i think there are some solutions that could play a role and the synchronization that was talked about but also to take the medication so if you are a person with those multiple chronic conditions with four or five steps to take and business on an empty stomach but to help that patients may be the role the pharmacist for the nurses could play as a team to help the person figure out what is the right way to have the medications throughout the day. running into more disability program it is intimidating did i already take that? how can we provide more tools to help people to get them lined up and then to build some assistance. >> very thoughtful and i amount of time but anything you'd lik

dr. hoadley. >> thank you. i do appreciate this opportunity to talk about my ongoing research work on the record of part d since the law was passed. part d really marks several first and that medicare. it was the first outpatient drug coverage for medicare beneficiaries. the first part of medicare solely available through private plans. the first time medicare they had provided assistance to low- income beneficiaries not relying on medicaid to provide that. and a gap in coverage also as we looke doan -- at the record of party over the time since it started, there are successes but ongoing issues and concerns. i want to mention a few a beach. the successes. the cost of part d has been 30% lower than the initial budget projected. that is an important thing. something we do not often get to talk about. -- but the a result program has been able to take advantage of the lower spending trend on prescription drugs over the. of time. lower enrollment has been a factor, although not one of the ones that we should be hap