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:
"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 |