Unintended Consequences of Medicare Part DIn an article, “How The Medicare Doughnut Hole Is Making American Seniors Sick,” Jeremy Cockerill talks about the heath consequences of seniors hitting the donut hole under Medicare Part D. He says,
An estimated 7 million Medicare Prescription Drug Plan beneficiaries will hit the coverage gap in 2007. Hitting the doughnut hole can have very serious health consequences for seniors. In fact, it can even potentially result in death.
He quotes a 2006 study published in the New England Journal of Medicine called, "Unintended Consequences of Caps on Medicare Drug Benefits," that found that drug plans with a cap on drug coverage (such as the doughnut hole in the Medicare Drug Plan) have an annual death rate that is 22% higher than plans that do not limit drug benefits. In addition, the study found that individuals whose benefits were capped were less likely to adhere to their long-term prescription drug therapies once they reached the coverage cap. This led to significant increases in hospitalizations and emergency room visits.
Cockerill suggests that by creating a gap in coverage in Part D, Congress actually created the potential for a major health crisis for seniors once they hit the doughnut hole. As drug prices continue to rise each year, seniors will be at greater risk of hitting the donut hole and being unable to afford their medications while there. From April 2006 to April 2007, Medicare drug plan prices increased 9.2% on the top 15 drugs prescribed to seniors.
These price increases, combined with the doughnut hole, will lead to a vicious cycle of non-adherence to drug therapies and poor health outcomes. During the time of year when seniors are hitting the doughnut hole (usually in the late summer and fall months) many will simply stop taking their medications. Come January, when a new Medicare benefit year begins, seniors will start up their therapies again. That is, if they were able to survive the doughnut hole.
With the death of my step dad, I’ve been less aware of the donut hole this year. But obviously it continues to be a problem.
Labels: Medicare Part D