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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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