Study find that lack of financial assistance to cover the cost of drugs to Medicare beneficiaries could result in an additional 18,000 patients discontinuing one or more prescriptions for essential drugs and others to not take their required medications.
The US government health insurance program for people 65 and over, Medicare part D covers over 50 million us citizens.
The study lead by Jennifer Polinsky from the Brigham and Women's Hospital in Boston and published in PLoS medicine found that patients advised by Medicare and Medicaid to consider switching to generic or lower cost drugs, in reality, due to lack of financial assistance most do not switch drugs.
Researchers examined the impact of government policy on medication using the data from 663,850 Medicare beneficiaries who made prescription claims in 2006-2007. The study found that in 2006 the government introduced Medicare Part D to help people pay for their drugs; Patients had to pay for their own drug cost once past the threshold of $2830. Three to Four million beneficiaries remained in the coverage gap maxing over the threshold every year until 2010. In 2010 US health reforms mandated the gradual reduction in the amount that eligible patients have to pay for their prescriptions once reaching the Medicare threshold.
Although this study did not directly investigate the effect of the coverage gap on patient outcomes, these findings suggest that this blunt cost-containment approach could adversely affect health outcomes through their negative effects on medication use.
"Blunt cost-containment features such as the coverage gap have an adverse impact on drug utilization that may conceivably affect health outcomes." said Polinsky.
Researchers advise that instead of blunt cost sharing approaches, a better clinically informed insurance strategies that promote specifically use of drugs with high benefit and low cost may hold more promise for government seeking to improve the healthcare beneficiaries.