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Study looks at the effect of Medicare prescription drug "doughnut hole" effects beneficiaries

22 08 08 - 11:40



Medicare gap and drug lapses

Many people in Medicare with diabetes, high blood pressure and other chronic conditions stop taking their medicine when faced with picking up the entire cost of their prescriptions, researchers say.

About 3.4 million older and disabled people hit a gap, known as the doughnut hole, in their Medicare drug coverage in 2007. When that happened, they had to pay the full cost of their medicine until they spent $3,850 out of pocket. Then, insurance coverage would kick in again.


In Minnesota and six other states making up the Northern Plains region, 33 percent of beneficiaries hit the coverage gap. Only Hawaii was higher, at 36 percent, while Nevada was lowest at 12 percent.

"We have no clue" about exact numbers of Minnesotans who hit the doughnut hole, said Jean Wood, executive director of the Minnesota Board on Aging. But it could be 160,000 Minnesotans if the state mirrors the total region. She urged Minnesotans who hit the gap to seek help from the Minnesota LinkAge Line, 1-800-333-2433.

About 15 percent of those hitting the coverage gap stopped their treatment regimen. That rate varied depending upon illness. For example, about 10 percent of diabetes patients stopped buying the medicine, as did 16 percent of patients with high blood pressure and 18 percent of those with osteoporosis.

Most participants say they are satisfied with the drug-benefit program. But many lawmakers and health analysts say improvements could be made.

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