Faced with Medicare coverage gap, seniors dropping meds, study finds

FRANKLIN LAKES, N.J. Alarming numbers of seniors with high cholesterol are dropping their drug therapy rather than paying out-of-pocket for their medications once they reach the Medicare Part D drug coverage gap, according to new research from Medco Health Solutions, Inc.

The Medco study, whose results were  unveiled last week, found that Medicare beneficiaries who were prescribed cholesterol-lowering statins are nearly twice as likely to abandon their medications when they reach the coverage gap, or donut hole, and become responsible for paying the entire cost of their medications, than they are in the initial phase of the benefit when the cost of the medication is covered. The result “may put them at higher risk for heart attack and stroke,” warned the pharmacy benefit management giant.

The study, conducted last year, showed the price-sensitivity of older Americans when confronted with the drop in coverage: the rate of patients who suspended generic statin treatment was 20 percent lower than those on a brand-name medication.

“This research confirms the concerns related to patient health in the coverage gap, and also validates the positive impact generics have on helping patients remain compliant with their medications,” said Dr. Woody Eisenberg, chief medical officer of Medco Retiree Solutions.  

According to the Medco research, 22 percent of Medicare Part D recipients reached the gap by July 2007. By December of last year, the company reported, “exactly half were either in the gap or had such high costs that they had proceeded to the catastrophic coverage phase of the benefit.”