Medicare Part D report: Fewer seniors skip drugs, but obstacles remain

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A recently published study presents a mixed view of the Medicare Part D prescription drug benefit's impact: While more seniors have coverage and fewer are skimping on daily needs to pay for drugs, many of the sickest patients still cannot afford their medication.

Cost-related adherence to prescription plans under Part D is better overall, according to the report, whose findings appear in the April 23 issue of the Journal of the American Medical Association. Only 11.5% of people didn't fill or receive prescriptions because of the cost in 2006, compared with 14.1% the year before Part D took effect in 2006.

However, report authors say there was no significant change in the skipping of medication among the sickest beneficiaries who require the most medication. One reason for this problem could be the Part D "doughnut hole," a gap in coverage between $2,250 and $5,100 in which patients must cover the full cost of their drugs. People whose prescription drug needs are costly enough to fall within this gap might not have the financial wherewithal to get their medication, and have no recourse within the Medicare system.