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Avalere Study Shows Medicare Part D Helping People with Type 2 Diabetes; Warns People with Diabetes of Probability of Reaching the 'Donut Hole'
Date:3/13/2008

WASHINGTON, March 13 /PRNewswire/ -- Medicare Part D has improved drug coverage and lessened the financial burden for many beneficiaries with type 2 diabetes, says a new study released today by Avalere Health at its Forum on Diabetes event.

The study is the first to use a large, national claims dataset to examine the effect of Part D enrollment on drug utilization and out-of-pocket costs for enrollees with type 2 diabetes. In addition to exploring utilization and cost data, the study also shows that the majority of enrollees with type 2 diabetes that reached the coverage gap, or "donut hole," threshold in 2006 did so by August, but this experience did not precipitate a drop in the number of prescriptions filled after that point.

Medicare Part D ushered in sweeping changes to the Medicare program, with the intent of creating affordable access to drug coverage for all seniors, thus improving their ability to purchase necessary prescription drugs and better manage their health. While recent public opinion research has shown high consumer satisfaction with Part D, little quantitative research has been published to test the actual effects of Part D on seniors' out-of-pocket costs and access to drugs.

The new Avalere study pulls back the curtain on the first two years of the drug benefit to see if Part D is meeting its stated policy goals with respect to diabetes. Its findings bode well for people with type 2 diabetes. First, most drugs used to treat diabetes and its two most common co-occurring conditions -- hypertension and dyslipidemia -- are widely covered by Part D health plans, at rates of 85-88 percent, and on tiers 1 and 2 of plan formularies which are associated with the lowest co-payments. By comparison, previous Avalere analysis shows that Part D formularies include an average of 75 percent of antipsychotic drugs and 88 percent of antidepressants, classes of drugs designated by the government as "protected."

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SOURCE Avalere Health
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