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Medicare Drug Program News
Four Million to be in Medicare Drug Program Doughnut
Hole by End of Month
Survey finds 16%
dropping medications rather than go to generics
September 21, 2006 –By the end of this month, four
million Medicare-eligible senior citizens and disabled, averaging seven
prescriptions per month, are estimated to fall into the Medicare Part D
"doughnut hole," a nearly $3,000 coverage gap where their drugs are no
longer paid for by their drug plan, yet, they must continue to pay the
monthly premium. A new study indicates about 16 percent will just stop
taking their medications.
The study released today by Wolters Kluwer Health,
projects that by year's end, 35 percent of all Medicare Part D enrollees
or approximately six million people will have entered the "doughnut
hole."
According to this new data, those who fell into the
doughnut hole this year chose to discontinue therapy 16% of the time
across all non-acute therapeutic categories. Some discontinuance rates
were considerably higher, for example, the anti-arthritics category saw
a 33.4% drop in usage. The findings also indicate a 4% increase in brand
utilization across all non-acute therapies during the period
January-August 2006.
"Faced with a coverage gap, patients tend to remain
loyal to the therapies that they believe to be most beneficial," said
Chris Messner, Product Management Director of Wolters Kluwer Health's
Pharma Solutions business unit.
"Rather than switching from branded therapies to
generics as a means of cutting costs, the data indicates a significant
number of seniors are taking prescription decisions into their own hands
and dropping therapies altogether."
Jonathon Gruber, PhD, Professor of Economics,
Massachusetts Institute of Technology noted that, "these facts are
worrisome, as it appears these behavior changes could cause higher
health costs as a result of increased hospitalization rates."
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Senior Citizens About to Face Their Medicare Drug
Plan Decision, Again
Enrollment opens Nov. 15 to change to
better plan
September 14, 2006 – Remember the agony you went
through last year in trying to figure out which of Medicare's multitude
of prescription drug programs you should join? Guess what, senior
citizens are about to have a chance to do it all over again, if they are
not happy with last year's choice – many may not be due to a change
in their drug needs.
Read more...
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According to the 2006 Medicare Part D plan,
standard enrollees pay the first $250 of medications. After reaching
that initial deductible, 75 percent of their drug costs are covered.
However, once total annual drug costs exceed $2,250, the enrollee must
pay the full cost out-of-pocket until costs surpass $5,100, the level
when catastrophic coverage begins. This $2,850 gap in coverage is known
by many as the doughnut hole.
"This year, the vast majority of Medicare enrollees
selected the lowest premium option without completely understanding the
potential financial impact of the coverage gap," said Messner. In fact,
there are alternative Part D plan options that offer coverage during the
gap for a higher premium.
"Depending on the health of the individuals, these
options may be better choices," continued Messner. "Since 2006 was the
first year for Medicare Part D, we anticipate that greater efforts will
be made to increase patient awareness about the various plans offered.
It will be critical to expand education not only to seniors, but to
family members who can help in their decision-making process."
The enrollment period for 2007, when current Part D
enrollees can upgrade or change their coverage without a penalty, runs
November 15 through December 31, 2006.
The Wolters Kluwer Health study looked at a
significant sample of Standard Eligible Medicare Part D patients who
were enrolled from January through August 2006.
For more information about Source products and
Wolters Kluwer Health, visit
www.wkhealth.com.
Notes:
Wolters Kluwer Health (Conshohocken, Pa.)
is a leading global provider of information for professionals and
students in medicine, nursing, allied health, pharmacy and the
pharmaceutical industry. Major brands include Lippincott Williams &
Wilkins and Facts & Comparisons for medical and drug reference tools and
textbooks; Ovid Technologies, Medi-Span and ProVation Medical for
electronic information; and Adis International and Source for
pharmaceutical information.
Wolters Kluwer is a leading multinational
publisher and information services company. The Company's core markets
are health, corporate services, financial services, tax, accounting,
legal, regulation, and education. Wolters Kluwer has annual revenues
(2005) of euro 3.4 billion, employs approximately 18,400 people
worldwide and maintains operations across Europe, North America and Asia
Pacific. Wolters Kluwer is headquartered in Amsterdam, the Netherlands.
Its shares are quoted on the Euronext Amsterdam (WKL) and are included
in the AEX and Euronext 100 indices. For more information, see
www.wolterskluwer.com.
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