PHOENIX, Sept. 21 /PRNewswire/ -- A study released today by Wolters Kluwer Health, a global provider of drug and medical information services and content to the healthcare and pharmaceutical industries, 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," a nearly $3,000 coverage gap inherent to the new Medicare drug prescription plan. By the end of this month alone, a total of four million Medicare-eligible seniors and disabled, averaging seven prescriptions per month, are estimated to enter the gap.
According to the new data, those who fell into the doughnut hole this year chose to discontinue therapy 16 percent 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 percent drop in usage. The findings also indicate a 4 percent 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."
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. A capsule case history is available to the media by contacting Tom Kivett at firstname.lastname@example.org.
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About Wolters Kluwer Health
Wolters Kluwer Health (Conshohocken, Pa.) is a leading 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(R) 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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Source: Wolters Kluwer Health