Diabetes Medications Could Suffer From Drug Spending Caps

Diabetes medications are necessary for chronic illnesses like diabetes but many seniors have to stop taking them when they go beyond their drug plan's annual spending limits. The drug spending caps made some seniors stop taking key medicines. This finding has been reported by a Rand Corporation research.

This study which observed how seniors registered with a national private health plan reacted, gives insight into what responses seniors have under the Medicare's new drug plan. This will leave about a third of those registered without coverage for diabetes medications for some part of the year when the quota is reached.

Geoffrey Joyce, Rand's lead author of this study, said that prescription use falls considerably when the patients reach their limit. So this is troubling because most of the drugs studied by Rand, a nonprofit research organization, prevent complications. Therefore there will be unfavorable health effects for seniors who reach their limit.

This research examined the use of prescription drug from 2003 to 2005 of more than 60,000 patients enrolled in the plan for retirees. The prescription drug examined included diabetes medications. There were two plans offered with a drug benefit limit of $1000 or $2500 and another with no limit.

For each plan the enrollee had to pay part of each drug purchase. Of those enrolled, the study found about 6% to 13% reached their limit in each of the years. Half of these went without benefits for more than three months. The trouble is that when the benefits resume at the beginning of a new plan year, a considerable number of seniors do not restart their treatment including the use of diabetes medications.

These findings were reported in the September/October issue of the journal "Health Affairs". Dana Goldman, the director of health economics at Rand and this study's senior author, said that this is worrying for although drug limits are a cost-saving measure, the results of the study show that in the long run this may result in more medical costs due to more hospital admissions.

Medicare Benefits are of two parts: Parts A and B, It is highly recommended for diabetics to get Medicare Part B. However, neither covers diabetes pills. Medicare Part C is not available everywhere and it covers almost the same as what Parts A and B cover. Yet one is required to get Parts A and B before qualifying. It was good that by January 1, 2006, it is no longer available in its old form.

By December 2003, the Medicare Modernization Act was passed. This allowed people on Medicare to enroll in Medicare-Approved Drug Discount card which allowed them to save money until the Part D prescription drug benefit began in January 2006.

It is hoped that the policy makers will take this into consideration. Coverage for preventive care like how to prevent diabetes is key and in 2005 Medicare started offering screening test. This way people can work on reversing diabetes through lifestyle changes. Hopefully then they may not have any need for diabetes medications.



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