When Medicare stops paying for seniors’ medications after they enter the Part D “donut hole,” the seniors often go without the drugs, even if the medications are essential for heart health, new research shows.
A study included more than 120,000 Medicare beneficiaries with cardiovascular conditions who were receiving drug benefits in 2006 and 2007. During that time, those seniors who reached a total of $2,250 in spending on prescription drugs in 2006 or $2,400 in 2007 lost further drug coverage until they reached the amount required for catastrophic care coverage ($3,600 in 2006 and $3,850 in 2007). This coverage gap is commonly referred to as the Medicare Part D “donut hole.” Most of these seniors had high blood pressure, and about one-third had congestive heart failure.
For their research, the research compared almost 4,000 of these seniors who lost coverage and had no additional coverage to a matched group of almost 4,000 seniors who lost coverage, but had additional financial assistance (such as additional insurance) to help pay for drug costs.
The group who had no additional financial assistance was 57 percent more likely to stop taking the drugs altogether when they reached the initial Medicare limit, according to the study. Neither group was likely to switch medications.
With most pharma companies offering free or heavily discounted drugs to patients you might be asking “why is this happening ?” It’s happening because in order to get these discounted drugs you need to literally jump through a lot of hoops and enter a maze. Seniors don’t have the patience to deal with this layer of bureaucracy which often makes them too frustrated. If big pharma wants to make a difference than what they really need is one organization which can act as a clearing house to distribute low cost of free drugs to people who cannot afford them. This also included makers of generic drugs as well.
It’s not enough to offer a helping hand you have to let people know it’s there.
- HelenCare: Giving Seniors Peace of Mind and More Money in Their Pockets (whitehouse.gov)
- Medicare Drug Plans Save $2.1 Billion (momentumtoday.com)
- Heart Meds May Get Lost in Part D Coverage Gap – MedPage Today (drugstoresource.wordpress.com)
- Patients often stop taking heart drugs during Medicare coverage gaps (eurekalert.org)