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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 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 as of 7/5/2012

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High Drug Prices Make Americans Sicker; Affordable Care Act Will Help But Too Slowly

Americans die and get sicker every day because they can’t afford their medications.

The Patient Protection and Affordable Care Act will help provide health insurance for millions of Americans, reducing the cost of their medications. But we’re not there yet! We’ve compiled statistics – see below – on the negative health effects of prescription non-adherence due to cost.  Our country needs greater access to safe and affordable medication now, including through verified international online pharmacies that offer far lower prices on essential medications.

Here are the stats:

  1. 25 million Americans report becoming sicker because they are not taking medication due to its cost. 1
  2. An estimated 150 million prescriptions go unfilled each year due to prescription costs.2,3
  3. 125,000 deaths occur per year among patients with heart disease due to prescription non-adherence. And that’s just for heart disease. The number of deaths per year among all conditions due to cost-related non-adherence is unknown. 4
  4. Americans who skip medication due to cost are almost twice as likely to experience a significant decline in overall health over 2 years of follow up.5

  1. USA Today/Kaiser Family Foundation/ Harvard School of Public Health Health Care Costs Survey, 2005. 20% of survey respondents report not filling a prescription due to cost; and 54% of those said their condition got worse as a result. Extrapolated to the 2012 population of adults 18 and older, (234,564,071), that is 25 million.
  2. McCarthy R. The Price You Pay for the Drug Not Taken. Business Health 1998. Reports that 20% of prescriptions go unfilled, and 15% of those go unfilled because the drug costs are too high.
  3. IMS National Prescription Audit PLUS reports 4.024 billion prescriptions dispensed in 2011. If 80% of prescriptions written are dispensed, then 5.03 billion prescriptions were written. 15% of 20% of 5.03 billion is around 150 million prescriptions forgone due to cost.
  4. McCarthy, R. The Price You Pay for the Drug Not Taken.Business Health 1998. Quote from Daniel Gerner, chairman at the time of Healthcare Compliance Packaging Council.
  5. Heisler et. al, The Health Effects of Restricting Prescription Medication Use Because of Cost. Medical Care, Volume 42, Number 7, July 2004
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Why Do Americans Need Greater Access to Safe International Online Pharmacies?

The simple answer is that tens of millions of Americans cannot afford prescription drugs here in the United States because they’re too expensive. Meanwhile, drug prices outside the U.S. are much lower – often 80% lower. Americans skipping or not taking prescription drugs is a national emergency largely going ignored in our healthcare debate.

Here are the facts about Americans skipping medication due to drug prices:

1.  25 million Americans did not take prescribed medication in 2009 due to cost, according to the U.S. Centers for Disease Control and Prevention. From 1997 to 2009, the percentage of Americans not taking their medications due to cost nearly doubled increasing from 4.8 to 8.4%.

Source: National Center for Health Statistics 2011.


2.  48 million Americans ages 19-64 did not fill a prescription due to cost in 2010, according to the Commonwealth Fund – a 66% increase since 2001.

Source: The Commonwealth Fund 2010 Biennial Health Insurance Survey,


3.  3.4 million Medicare enrollees stop taking their medication due to the coverage gap.

Source: Polinski JM, Shrank WH, Huskamp HA, Glynn RJ, Liberman JN, et al. 2011 Changes in Drug Utilization during a Gap in Insurance Coverage: An Examination of the Medicare Part D Coverage Gap. PLoS Medicine.


4.  Prescription non-adherence adds $290 billion to America’s healthcare costs. 

Source: U.S. Food and Drug Administration. 76 FR 12969. March 2011.

Access our RxSOS fact sheet here.

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