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Survey Maps Prescription Plan Gap

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Roughly 7% of Medicare beneficiaries who ran out of routine drug benefits in 2006 stopped taking their medications while they were “in the donut hole.”

Researchers at GfK U.S. Healthcare Companies, East Hanover, N.J., have published that finding in a summary of results from a March survey of 750 Medicare Part D prescription drug plan participants.

The Part D program provides coverage for routine drug use, and it also provides catastrophic coverage for beneficiaries whose prescription expenses exceed a designated level, but beneficiaries who run into the donut hole and do not also have state Medicaid coverage must find some way to use their own resources or help from others to pay for drugs.

About 20% of patients who were in a Part D plan before November 2006 ended up in the donut hole, GfK researchers report.

The researchers found that most patients who entered the donut hole used strategies other than doing without medications completely.

About 51% of those patients reacted to the gap by shifting to a cheaper generic product or by asking physicians for samples, and 21% reacted by using medications less often than prescribed; the researchers report.


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