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Helping Americans Get The Truth About Prescription Drug Savings
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New study on Medicare Part D reveals reversing fortunes for the most vulnerable seniors

The journal Health Affairs recently published an article titled “Medication Affordability Gains Following Medicare Part D Are Eroding Among Elderly With Multiple Chronic Conditions.” The article is about changes in and problems with affordable access to medication for all Medicare enrollees who are 65 and over, not just those with chronic conditions. It focuses on two different time periods, 2007 to 2009 and 2009 to 2011. The data shows that while Medicare Part D initially improved access to affordable medication, some of those gains were lost, and for seniors taking the most medications, the most vulnerable, improvements may have disappeared entirely.

In 2005, before Part D plans were available, the study noted that an estimated 14.9% of seniors experienced cost-related problems accessing prescription drugs (meaning they did not take medicine as prescribed due to cost), also called cost-related prescription non-adherence (CRN). CRN decreased to 11.3% in 2007. Then, surprisingly, following the worst economic downturn since the Great Depression (during which the average wealth of the elderly dropped 20%), the number decreased further to 10.2%.

During the economic upturn, however, the CRN figures crept back up to 10.8 by 2011. The same trend – a decline then an increase – happened for the percent of seniors forgoing other needs to pay for medicine (such as food and heat): 8.8 percent in 2005, 5.6% in 2007, 4.0%, but back up to 5.3% in 2011.

The CRN numbers are much worse for seniors with four or more chronic conditions, such as diabetes, cancer, hypertension, and asthma, among others, representing about 27% of all beneficiaries. (more…)

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Are Drug Affordability Problems Greater In America Than Elsewhere?

The answer is yes. Out of eleven developed countries, America is #1 when it comes to high drug prices preventing people from taking needed medications, according to a new international survey conducted by the Commonwealth Fund and reported on in Health Affairs.  Twenty-one percent of American adults – over 50 million people – skipped medication due to cost, more than double the 9% who did so in Germany, the second highest rate. In the United Kingdom, only two percent of adults reported skipping medication due to drug costs.

The disturbing number of Americans forgoing prescriptions is not solely due to our large uninsured population. In fact, the Commonwealth Fund data shows that 15% of insured Americans skipped prescription medication due to costs, often because of high plan deductibles, co-payments, or co-insurance, supporting our recent analysis that those who will become insured under Obamacare may, too, find drug costs out of reach and seek affordable medication internationally. Hopefully, reforms under Obamacare, such as requiring plans to cover at least one drug in each “class” of drug and the eventual cap on out-of-pocket spending, will help Americans more easily afford their medication.

The data also shows the extent to which high drug prices affect patients with chronic conditions; skipping meds prescribed for chronic conditions, such as high blood pressure, diabetes, and asthma, can lead to hospitalizations, emergency room visits, or even death.  Twenty-nine percent of Americans with chronic medical conditions skipped their meds due to costs, more than double the 14% of Australians, who had the second highest rate.  Only 1% of patients in the U.K. with chronic conditions skipped medication because of prices. Our conclusion? America can do better.

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