Seniors reduce or discontinue medications when faced with gap in drug coverage, UCLA study shows

Seniors who use up their yearly drug benefits before the end of the year often resort to reducing their recommended dosages, or even stop taking their medications altogether--a situation that could endanger their health, according to a new study co-authored by a UCLA researcher.

In a study of 1308 seniors with a yearly cap on drug benefits, 24 percent of seniors who used up their benefit two-and-a-half to six months before the end of the year said they used less of, stopped, or did not start at least one of their medications because of the out-of-pocket costs. Among the 10 medications most affected were those drugs for treating high cholesterol, hypertension, asthma, depression, and pain. Two-thirds of seniors who faced this gap in drug coverage said that it was difficult to pay for their medications. Nearly one in four experienced difficulty paying their rent and bills because of these costs.

This study illustrates what could happen to seniors who fall into the "donut hole" in the new $410 billion national Medicare drug benefit. Seniors initially pay only 25 percent of medication costs, but there's a "donut hole" between $2,250 and $5,100 when they have no coverage. Other studies estimate that 42 percent of Medicare beneficiaries, many of them with chronic diseases, will be affected by this gap in coverage.

This study is also relevant to the 4.6 million seniors who are currently enrolled in Medicare managed care. These health plans often are able to offer drug benefits by placing an annual dollar "cap" on drug benefits. Members who spend past this cap, like seniors in the study, face a "donut hole" because they pay for medications out-of-pocket until new drug benefits kick in the following year.

"We found that patients were making some pretty big financial trade-offs between paying rent or buying food and purchasing medications so they could cover their drug costs," said Dr. Carol M. Mangione, senior study autho

Contact: Enrique Rivero
University of California - Los Angeles

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