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Study finds drug spending caps cause some seniors to quit taking key medicines
Date:9/22/2007

going without benefits for more than 90 days, according to the study.

High spenders in the capped plans were more likely to discontinue use of their medications than people enrolled in the plan with no spending limits, according to researchers. Discontinuation rates differed by type of drug, ranging from 15 percent for anti-cholesterol medication to 28 percent for cardiac drugs. Rates were higher for pain medications and anti-ulcer drugs where over-the-counter alternatives were available.

Researchers say they were surprised that more people did not switch to generic drugs, given they are generally cheaper than name-brand medications. While people were less likely to quit using generic drugs once they reached benefit caps, no widespread move to the lower-cost alternatives was noted.

Among patients who stopped taking a medication in the capped plan, more than half did not restart their prescriptions during the first three months after benefits resumed.

Given the importance of these drugs, its distressing that the resumption rates are not higher, said Dana Goldman, the studys senior author and director of health economics at RAND. Drug caps are a cost-saving measure, but our findings raise the issue of whether in the long run they may lead to other medical costs such as increased hospitalizations.

Researchers said the study may help guide policymakers who are concerned with the so-called doughnut hole in Medicare prescription drug plans. Spending limits contained in the Medicare drug plan are expected to leave between 24 percent and 38 percent of enrollees without drug coverage for part of each benefit year.

Caps on prescription drug spending are not a prudent way to restrict costs, Joyce said. Cycling in and out of coverage is likely to have adverse health effects over time.


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Contact: Warren Robak
robak@rand.org
310-451-6913
RAND Corporation
Source:Eurekalert

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