Navigation Links
Avalere Estimates Medicare Part D 'Donut Hole' Will Be Obsolete in 2023
Date:7/1/2009

WASHINGTON, July 1 /PRNewswire/ -- Today's 65 year old Medicare Part D beneficiary will be 79 when the coverage gap, or 'donut hole,' is eliminated, says a new analysis of proposed legislation from the House of Representatives released today by Avalere Health. The firm also concludes that although fewer people will fall into the gap from now until 2023, by 2020 some of the sickest Medicare beneficiaries will spend upwards of $16,000 on drugs before reaching catastrophic coverage where the government covers 95% of their drug costs.

Using language proposed in the recent House legislation and its own analytic models, Avalere researchers assessed what would happen to the coverage gap over time if the proposed House legislation on this aspect of Medicare Part D were enacted. Among their findings:

  • The gap will be eliminated over time, but it will likely take 12 years based on the current House proposal.
  • Fewer Medicare beneficiaries will fall into the gap over those 12 years, because the legislation increases the rate at which the initial benefit limit and annual out of pocket threshold grow. Those likely to benefit immediately are those who rely on multiple chronic condition medications and do not take any biologic or specialty drugs.
  • The sickest beneficiaries who rely on certain categories of high-cost drug therapies currently get through the coverage gap and into catastrophic coverage after spending approximately $3,000 (based on current thresholds); under this proposal, it may take these beneficiaries thousands of dollars more annually than they are currently spending to reach catastrophic coverage support.

"Achieving greater beneficiary protection is clearly a difficult challenge given the construct of the benefit, cost concerns, and the wide variety of patient needs," said Jennifer Snow, a senior manager at Avalere Health. "The proposal we evaluated charts a path toward ending the unpopular donut hole, but does impose burdens on many chronically ill beneficiaries."

Avalere researchers point to other areas for future research related to coverage gap policies, including the cost of the proposal to the federal government, how it will affect beneficiary and plan behavior, and profiles of certain types of patients and how they would fare under this new proposal and the use of generic medications under Medicare Part D.


'/>"/>
SOURCE Avalere Health
Copyright©2009 PR Newswire.
All rights reserved

Related medicine news :

1. Avalere Shows Home Health Interventions Associated with Lower Medicare Spending and Re-Hospitalizations for Patients With Chronic Illness
2. Avalere Health Finds New Plan to Reform Medicare Post-Acute and Long Term Care System Could Save U.S. Approximately $35 Billion Over Ten Years
3. Avalere Examines Emerging Strategies for Managing Imaging Utilization
4. Avalere Report Shows Unapproved Prescription Drugs Dropped from CMS Formulary Reference File
5. Avalere Health Data Finds Four-Tier System Growing Among Medicare Part D Plans
6. Avalere Study Shows Medicare Part D Helping People with Type 2 Diabetes; Warns People with Diabetes of Probability of Reaching the Donut Hole
7. New Research From EBRI: New Estimates Update Retiree Health Savings Needs
8. Craneware Supports Hospitals Compliance and Upfront Collections with Accurate Estimates
9. Novel approach estimates nanoparticles in environment
10. Study examines radiation dose estimates for pregnant women undergoing therapeutic ERCP
11. Methamphetamine use cost the US about $23 billion in 2005, RAND study estimates
Post Your Comments:
*Name:
*Comment:
*Email:
(Date:6/26/2016)... ... June 27, 2016 , ... Quality metrics are proliferating in cancer care, and ... in the eye of the beholder, according to experts who offered insights and commentary ... of Managed Care. For the full issue, click here . , For the ...
(Date:6/26/2016)... ... June 26, 2016 , ... Many women are ... with endometriosis. These women need a treatment plan to not only alleviate symptoms ... can help for preservation of fertility and ultimately achieving a pregnancy. The specialists ...
(Date:6/25/2016)... ... June 25, 2016 , ... First Choice Emergency Room , the largest ... as the Medical Director of its new Mesquite-Samuell Farm facility. , “We are ... Mesquite location,” said Dr. James M. Muzzarelli, Executive Medical Director of First Choice Emergency ...
(Date:6/24/2016)... ... June 24, 2016 , ... A recent article published ... unfamiliar with. The article goes on to state that individuals are now more comfortable ... less common operations such as calf and cheek reduction. The Los Angeles area medical ...
(Date:6/24/2016)... ... June 24, 2016 , ... Global law firm Greenberg Traurig, P.A. announced that ... chosen by their peers for this recognition are considered among the top 2 percent ... special honors as members of this year’s Legal Elite Hall of Fame: Miami ...
Breaking Medicine News(10 mins):
(Date:6/24/2016)... 24, 2016  Arkis BioSciences, a leading innovator ... more durable cerebrospinal fluid treatments, today announced it ... funding is led by Innova Memphis, followed by ... private investors.  Arkis, new financing will accelerate the ... market release of its in-licensed Endexo® technology. ...
(Date:6/23/2016)... DUBLIN , June 23, 2016 ... "Dialysis Devices Global Market - Forecast to 2022" report ... is the treatment method for the patients with kidney failure, ... and excess fluid from the patient,s blood and thus the ... sodium, potassium and chloride in balance. Increasing ...
(Date:6/23/2016)... 23, 2016 Research and Markets ... Market by Type (Organic Chemical (Sugar, Petrochemical, Glycerin), Inorganic ... Coating, Parenteral) - Global Forecast to 2021" report ... The global pharmaceutical excipients market is projected to ... of 6.1% in the forecast period 2016 to 2021. ...
Breaking Medicine Technology: