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

r and professor of general internal medicine and health services research at the David Geffen School of Medicine at UCLA "Low income seniors with serious chronic conditions such as diabetes and hypertension are likely to have the greatest problems covering their share of medication costs. Given the huge annual inflation in drug costs, health plans are already hard pressed to provide drug benefits for persons with Medicare. Doctors can help patients make the most of their benefits or keep them from exceeding the cap by identifying when less expensive but potentially effective medications such as generics are appropriate."

The study, "Cost-Lowering Strategies By Medicare Beneficiaries Who Exceed Drug Benefit Caps and Have a Gap in Drug Coverage," is published in the August 25 issue of the Journal of the American Medical Association.

The study surveyed 1308 seniors in 2002, half of whom exceeded their cap in 2001 and had a gap in coverage for two-and-a-half to six months. The other half of participants had a higher benefit cap and coverage year-round. The researchers found that 24% of seniors who had a gap in coverage decreased their use of medications, compared to 16% of seniors who had year-round coverage. Many of the study participants called pharmacies for lowered prices (46%), asked doctors for samples (34%) or switched to lower cost medications (15%). Researchers were surprised that so many seniors with coverage year-round were also decreasing their medication use because of cost. In fact, one in three seniors who had coverage year-round said paying for medications was difficult.

"This study sends out an emergency signal to doctors that we need to be aware that seniors often only get a fixed amount of money from their health plans to cover their medications for the year," said Dr. Chien-Wen Tseng, the study's principal investigator and assistant professor of family medicine and community health at the John A. Burns Scho
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Contact: Enrique Rivero
erivero@support.ucla.edu
310-794-2273
University of California - Los Angeles
24-Aug-2004


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