KHN Morning Briefing

Summaries of health policy coverage from major news organizations

Study Finds Patients More Likely To Skip Diabetes Medicine While In The ‘Doughnut Hole’

Consumers experiencing a gap in their Medicare Part D prescription drug coverage were more likely to forgo diabetes medications than those who had supplemental drug benefits. Business Week reports: "Medicare's so-called 'doughnut hole' could be forcing many American seniors to skip their diabetes medications, a new study suggests."

The doughnut hole occurs because Medicare covers prescription drug costs up to a certain amount and then consumers must pick up the tab until they've hit another spending threshold. The study was based on 2006 data, "when Part D coverage included up to $2,250 in total drug costs paid by both the patient and plan. ... The plan started paying again when people reached $3,600 in total out-of-pocket drug expenses for the year."

Researchers from Kaiser Permanente and the David Geffen School of Medicine at the University of California, Los Angeles, conducted the study that "looked at the effect of the doughnut hole on drug costs and diabetes medication adherence among participants in two large health systems that offered Medicare D plans. People were classified as adhering to their medication if they filled their prescriptions at least 80 percent of the time. Compared with those who had supplemental drug benefits, people with the doughnut-hole coverage had higher out-of-pocket drug costs and were more likely to skip their diabetes medications, the study found" (Preidt, 1/7).

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