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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

sured via utilization, or how many prescriptions people take, and how much they are spending for those drugs. On both counts, Avalere's report points to improvements for Medicare Part D enrollees with type 2 diabetes. Out-of-pocket diabetes drug costs per prescription were 35 percent lower for standalone prescription drug plan (PDP) enrollees and 25 percent lower for Medicare Advantage prescription drug (MA-PD) plan enrollees, as compared to fellow Medicare beneficiaries who chose not to enroll in Part D. PDP enrollees were taking 11.2 percent more prescriptions and MA-PD enrollees 6.2 percent more prescriptions than before they had Part D coverage.

"Part D is meeting its goals of increasing access to, and affordability of, drugs to Medicare beneficiaries," said Valerie Barton, vice president of Avalere Health and co-author of the study.

A unique aspect of Part D is the coverage gap, or donut hole. To date, there has been much speculation on whether the coverage gap would be a hindrance to continuity of care and access to medications. Avalere found that 43 percent of non-Medicaid beneficiaries with type 2 diabetes enrolled in PDPs and 33 percent enrolled in MA-PDs reached the threshold by the end of 2006. In 2006, the majority who reached that threshold did so by August. But hitting the gap did not correlate with reduced use of prescription drugs, and in fact, the study showed no reduction in the number of prescriptions filled by patients with diabetes.

"Knowing when people with diabetes may hit the coverage gap is important for physicians who can look for signs of non-compliance, and for individuals who can use this data for financial planning purposes," said Barton. "The lack of change in the number of prescription drugs used invites more research on whether patients with type 2 diabetes tend to enroll in Part D plans that offered gap coverage, the financial sensitivity of patients with chronic illness, and generic switching patterns for patie
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SOURCE Avalere Health
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