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Helping Americans Get The Truth About Prescription Drug Savings
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Seniors in Medicare Doughnut Hole Skipping Depression Medication

A new study, reviewed in Medpage Today, finds that seniors falling into the Medicare Part D prescription drug coverage gap, often referred to as the “doughnut hole,” reduced the number of monthly anti-depressant prescriptions they filled by 12.1% compared to those with full coverage. In 2012, Part D plans share drug costs with enrollees up to $2,930. With co-pays, premiums, and deductibles seniors pay about $1,500 up to that point. After $2,930 the doughnut hole begins and plan enrollees pay out-of-pocket until they have spent $4,700 – after which the plans pay for 95% of drug costs.

The study also showed that those in the doughnut hole were more likely to go without other medications. Monthly use of heart failure drugs and anti-diabetics fell by 12.9% and 13.4%, respectively, relative to the group with full drug coverage. The study, Effects of Medicare Part D Coverage On Medication and Medical Treatment On Elderly Beneficiaries With Depression, was published in the July issue of Archives of General Psychiatry.

We’ve previously reported that the doughnut hole is a serious health issue for America’s seniors who are unable to afford needed medication. The new healthcare law offers seniors substantial discounts in the doughnut hole on brand name medications, and by 2020 the doughnut hole will supposedly be closed. The discounts help seniors to access medicine, but the crisis of skipped medicine will persist through the decade. Until then, it’s critical that seniors do not stop taking needed medications.

Medicare enrollees in the doughnut hole face very high drug costs for popular products such as Lexapro, Cymbalta and Abilify, all used to treat depression. These very medications are, on average, 80% less expensive if ordered from the lowest priced verified online pharmacies. See the chart below for price comparisons of verified international online pharmacies and a U.S. bricks and mortar pharmacy.

Prices for Three-month Supplies of Popular Anti-Depressants

Drug U.S. Bricks and Mortar Pharmacy* Lowest Pharmacy-Checker.com Listed Price** Savings Over 3 Months Percent Savings Savings Over 1 Year
Abilify 10 mg $1,881.99 $332.10 $1,549.89 82.35% $6.199.56
Cymbalta 30 mg $637.00 $133.20 $503.80 79.09% $6,199.56
Lexapro 10 mg $351.00 $84.61 $266.40 75.90% $1,065.60
Average: $956.66 $183.30 $773.36 80.84% $3,093

* Pharmacy in New York City, price collected 7/5/2012
**Lowest price listed on PharmacyChecker.com as of 7/5/2012

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PhRMA Criticizes Obama’s New Budget For Requiring More Rebates on Prescription Drugs

“President Obama just released next year’s budget proposal and it has already sparked fierce criticism from the pharmaceutical industry. That’s because the plan would require Big Pharma to give an additional $156 billion in drug rebates over the next decade.” 
 
This news comes from RxRight.org’s latest blog post, entitled Big Pharma balks at President’s proposed budget. Not surprisingly, as articulated by its president, John Castellani, the Pharmaceutical Research and Manufacturers of America is against the rebates and other reforms found in Obama’s budget. One point championed by Mr. Castellani as a reason to criticize President Obama is that the “Medicare Part D is working well for seniors.” While Part D has certainly helped many seniors afford needed medication, the RxRights post, and empirical data, show that millions of seniors still struggle to afford necessary, and sometimes life-saving, prescription drugs because of costs – despite Medicare Part D drugs plans. 
 
In fact, the failure of Medicare Part D is one reason that reputable international online pharmacies remain a lifeline for Medicare enrollees. It appears if Obama’s budget is approved, without changes to his prescription drug rebate requests, then more Americans will forgo the international option in favor of domestic pharmacies. 
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Save Money on Medicare Drug Plans by Shopping Around – Open Enrollment Starts This Friday

An article published last week in Reuters suggests that Medicare Part D drug plans may be dropping premium prices – an effect of the healthcare reform law which could greatly benefit seniors if they shop around. Reevaluating your Medicare drug plan yearly during the open enrollment period is always a good idea, but this year plan selection could make a big difference.

Although we reported in August that plan premiums will not raise in 2012, Avalere Health, a health policy consulting firm, finds that while 10 of the top Part D plans will lower prices, six plans will raise premiums. However, the good news is that in the larger picture Avalere “projects that average premiums for both prescription drug and Advantage plans will fall 4 percent for 2012.” Because of the 2010 heath reform law, Dan Mendelson, Avalere Health’s CEO, is calling this a “year of change.” He tells Reuters, “It’s a year where patients really need to shop.”

MedicareDrugPlans.com provides ratings and reviews – along with basic plan information such as deductibles and premiums– for consumers to access during their research period. Ratings and comments help Medicare enrollees understand the pros and cons of a plan, and user comments and forum posts give details on what other Americans experienced with their plans.

Open enrollment will be from October 15th – December 7th this year, a change from previous years meant to give Medicare enough time to process all changes and new enrollees, and for consumers to manage their health needs before the busy holiday season.

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