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CMW News: Some patients stop taking medications due to drug coverage gap

Case Management Weekly, August 27, 2008

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Elderly patients with chronic conditions face a tough choice after their total Medicare drug spending has exceeded $2,400. They must either pay for their medications out of pocket or stop taking them.

Medicare drug benefits do not kick in again until patients have spent more than $3,850. And in 2007, about 15% of the 3.4 million Medicare beneficiaries who hit this drug coverage gap, known as the doughnut hole, quit taking their medications. The percentage of patients who stopped taking their medications varied by condition. For example, about 8% of patients stopped taking medications for Alzheimer’s disease, while 20% stopped taking medications for acid reflux disease.

The doughnut hole program was put into place by Congress in 2003 as a way to cut spending. Many lawmakers and analysts say improvements can be made to the program and look to a newly elected president and Congress to make those decisions.

Sources: Health Leaders Media, Yahoo! News



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