Drug Makers Agree to Shrink Medicare D’s Donut Hole
President Obama announced on Monday that the pharmaceutical industry has collectively agreed to dramatically reduce the cost of prescription drugs, including brand name drugs, to Medicare beneficiaries facing the dreaded donut hole in the program’s Plan D prescription option. The president gave strong praise to the nation’s drug makers for taking the initiative to help reduce the skyrocketing cost of national health care.
The pharmaceutical industry has agreed to reduce the cost of individual prescription drugs by 50% or more when the Medicare beneficiary has reached the Plan D dollar-amount threshold. The plan pays almost all prescription costs until an individual has accrued $2,700 in prescription benefits in a single year. This $2,700 is the threshold that signals the end of prescription benefits until that same individual accrues prescription expenses of $6,100 in the same year. After reaching the $6,100 mark, Medicare prescription benefits begin again.
The gap between $2,700 and $6,100 is the donut hole that wreaks havoc on the tightly fixed incomes of many American senior citizens. While in this donut hole of zero prescription benefits, Medicare beneficiaries are required to pay 100% of their prescription medication needs entirely out of pocket. Facing this gap in prescription expense coverage, many senior citizens are forced to stop life-enhancing medications or take fewer and smaller doses than their prescriptions call for. Others forfeit food and utility money to maintain their prescriptions.
By reducing prescription costs to Medicare recipients working through this donut-hole period of no coverage, the pharmaceutical industry anticipates a nationwide savings of $80 billion over a 10-year time span.
Even though calling this initiative by drug makers a “significant breakthrough” and just the kind of compromise required to successfully reform the nation’s healthcare system, the president warned the Plan D compromise must be voted in by all Congressional committees working on healthcare reform before it becomes a reality.
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I use my $2700.00 allowance in the first 3 month supply of prescription drugs I have to take due to emphysema and COPD I cannot take generics as there are none available. My income is very restricted due to having a spouse in assisted living with advanced Alzheimer’s. The so called donut hole forces me not to take my medication as prescribed (1 x a day instead of 2) Where is the help for Me?
I think it is right that health reform must change! After all, it affects the health of the nation!
If you must spend the money between 2700 and 6100 before you get out of the donut, it doesn’t matter whether the drug companies drop the price or not. If your drugs cost $340 a pop, under current plan you must refill 10 times to fulfill donut. Under the new plan (50% off)you would have to refill 20 times but it’s the same amount of money. Only savings is if you roll over into a new year.