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Medicare Prescription
Drug Benefit improved access to medications
for most Seniors, but sickest Seniors
continued skipping pills because of cost
issues, study finds
The percentage of seniors who said they skipped taking
medications because of costs declined after
the Medicare prescription drug benefit took
effect in January 2006, but the sickest
beneficiaries still skip prescriptions
because they cannot afford to pay for them,
according to a study published Wednesday in
the
Journal of the American Medical Association,
Reuters reports.
For the first study, Jeanne Madden and
colleagues from
Harvard Medical School analyzed data
from a government survey of 24,234 Medicare
beneficiaries in 2004, 2005 and 2006 and
found that 11.5% reported skipping
medications in 2006, after the drug benefit
was introduced, compared with 14.1% in 2005.
The study also found that in 2006, 7.6% of beneficiaries cut
back on spending for basic needs, such as
food or housing, to afford medications,
compared with 11.1% in 2005.
However, beneficiaries classified as the
sickest reported no improvement in skipping
prescriptions because of cost. These
beneficiaries, who account for 27% of
overall Medicare Part D enrollment, skipped
pills at about twice the rate of healthier
people in 2004 and 2005, according to the
study.
An abstract of the study is available
online.
Cost Issues
A separate study also published in
JAMA
on Wednesday found that 36% of Medicare drug
plan beneficiaries reported changing their
behaviors in some manner after enrolling in
the drug benefit because of costs, including
switching to a less-costly drug, not
refilling a prescription or experiencing
financial burden. For the study, lead author
John Hsu of Kaiser Permanente's Center for
Health Policy Studies and colleagues in 2007
surveyed 1,040 Medicare beneficiaries who
were enrolled in the drug benefit.
Researchers also found that 60% were unaware
their plans had the so-called "doughnut
hole" coverage gap. "The new Medicare Part D
program provides billions of dollars in new
benefits for seniors, but also imposes
complex and high levels of cost-sharing,"
Hsu said in a statement, adding, "The study
shows that many seniors have trouble
understanding these benefits and that this
poor knowledge limits their ability to
manage their medication needs and costs"
(Dunham,
Reuters,
4/22).
Please note:
The Kaiser Family Foundation is not
associated with Kaiser Foundation Health
Plan, Kaiser Permanente or Kaiser
Industries.
An abstract of the study is
available
online.
Commentary
"Medicare
Part D: A Successful Start With Room for
Improvement,"
JAMA:
The
JAMA editorial by Dana Goldman
and Geoffrey Joyce, both of the
RAND Corporation and the
National Bureau of Economic Research,
discusses successful aspects of Medicare
Part D, as well as emerging concerns,
including increasing copayments and changes
in medications. The authors also examine
whether the doughnut hole gap is generating
nonadherence to drug regimens
(Goldman/Joyce,
JAMA,
4/23).
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