Medicare Drug Cap Didn't Save Money, Study Finds: Savings Offset By Cost of Emergency Care, Researchers Say.
Posted on: Friday, 2 June 2006, 21:00 CDT
By Nancy Weaver Teichert, The Sacramento Bee, Calif.
Jun. 1--Benefit limits on prescription drugs covered by Medicare health plans didn't save money because patients stopped taking needed medications and ended up sicker, a new study has found.
Any savings in drug costs were offset by increased emergency care and hospitalizations among seniors, researchers at Kaiser Permanente reported in today's edition of the New England Journal of Medicine.
The study is the first to calculate the clinical and economic effects of a cap on drug benefits. It predates the new Medicare prescription drug benefit.
The study of 200,000 Medicare beneficiaries in Northern California, including Sacramento, found that those who hit the drug cap stopped or reduced their medications, resulting in higher blood pressure, blood sugar and cholesterol levels.
"The net effect was no savings. One can't look at drug costs alone," said lead researcher and author Dr. John Hsu. "You have to look at the whole health care picture for patients as well as society at large."
The study compared the health of patients on Medicare Plus Choice health plans, who had a $1,000 cap on prescription drugs, to the health of patients with no caps because their employers subsidized their drug coverage.
Those with caps spent 31 percent less on prescriptions, but their overall medical costs were the same because of more visits to the emergency room and hospital.
Hsu said the theory has been that benefit caps result in doctors and patients using medications more judiciously, thereby lowering costs and keeping coverage affordable.
The study concludes that isn't the case. Because of benefit limits, patients didn't take medications that could have managed their chronic health conditions in a cost-effective way.
"Drug coverage has a substantial effect on patients' health," said Hsu. Patients who took fewer drugs due to caps suffered "substantial adverse effects" on their health, including higher mortality rates, he said.
Medicare's new Part D prescription drug plans all offer more generous coverage than those available to people in the 2003 study.
But Hsu said there's still a need to study the impact of the new plans because they contain varied benefit caps, such as the "doughnut hole," or gap in coverage, during which beneficiaries pay 100 percent of drug costs.
"With any of these plans, it's very important to monitor the medical and economic effects both for individual patients and for society," said Hsu.
-----
Copyright (c) 2006, The Sacramento Bee, Calif.
Distributed by Knight Ridder/Tribune Business News.
For reprints, email tmsreprints@permissionsgroup.com, call 800-374-7985 or 847-635-6550, send a fax to 847-635-6968, or write to The Permissions Group Inc., 1247 Milwaukee Ave., Suite 303, Glenview, IL 60025, USA.
Source: The Sacramento Bee
Related Articles
- Avalere Health Finds New Plan to Reform Medicare Post-Acute and Long Term Care System Could Save U.S. Approximately $35 Billion Over Ten Years
- Study Shows PillCam(R) ESO Reduces Prison Health Care Costs By 90% for Cirrhotic Patients
- Senior Whole Health Expands Medicare Advantage Special Needs Plan Coverage Area to Include Fairfield County, Conn.
- Survey of Over-65 Population By Erickson Health(SM) Shows Top Fears Are Rising Health Care Costs and Changes in Medicare
- Health Net of Arizona Will Launch a Medicare Special Needs Plan Supported By Alere Medical
- Study Finds Amendment 2 Will Benefit Hundreds of Thousands of Patients, Reduce Health Care Costs and Boost Economy
- FTCR: 'Health Savings Accounts' Require Patients To Pay More But Do Nothing To Slow Increasing Health Care Costs
- New Complementary and Alternative Health Plan Coverages Now Available to Employers in the State of Texas
- Medicare drug benefit to cost less, official says
- Direct Health Care Costs of Diabetic Patients in Spain
 |
 |
User Comments (0)
RSS Feeds