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Not Understanding Medicare Part D Still an Issue |
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From EurekAlert! - Breaking News: There still appears to be some lack of knowledge regarding Medicare's Part D prescription drug program, although there is evidence that cost-related medication nonadherence may have improved overall, according to two studies in the April 23/30 issue of JAMA. Before implementation of the Medicare Prescription Drug Improvement and Modernization Act, which was passed by Congress in 2003, millions of individuals who were elderly and disabled had insufficient or no insurance coverage for outpatient medications. Such cost-related medication nonadherence (CRN) is associated with increased risk of myocardial infarction, stroke, and preventable hospitalization," the authors of the first study write. Since January 2006, Medicare beneficiaries have been able to purchase a prescription drug benefit (Part D), subsidized by Medicare and available through private plans. The researchers found that there was a larger absolute decrease in CRN following Medicare Part D implementation (from 14.1 percent in 2005 to 11.5 percent in 2006) than occurred between 2004 and 2005 (15.2 percent to 14.1 percent, respectively). However, no significant changes in CRN were observed among beneficiaries with fair-to-poor health, despite high baseline CRN prevalence for this group (22.2 percent in 2005) and significant decreases among beneficiaries with good-to-excellent health. Those beneficiaries in poor health or with multiple morbidities who had substantially higher baseline CRN did not experience decreases in CRN associated with Part D implementation, although they did report reductions in spending less on basic needs. In comparison with commercial insurance, Part D benefits use complex and high levels of cost sharing to help limit drug costs, including a coverage gap that in 2006 started at $2,250 in total drug costs and ended after $3,600 of beneficiary out-of-pocket spending.
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