Posting date: April 19, 2005

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Health Affairs, 10.1377/hlthaff.w5.167
Copyright © 2005 by Project HOPE

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Assessing The Impact Of Coverage Gaps In The Medicare Part D Drug Benefit

¹ Bruce Stuart is a professor and director of the Peter Lamy Center on Drug Therapy and Aging, Department of Pharmaceutical Health Services Research, University of Maryland School of Pharmacy, in Baltimore.
² Linda Simoni-Wastila is an associate professor at the center.
³ Danielle Chauncey is a doctoral student at the School of Pharmacy.

^*Corresponding author.

Abstract

The new Medicare Part D drug benefit contains major coverage gaps for people who spend moderate to high amounts on prescription drugs who qualify only for the standard coverage. To help policymakers understand the impact such gaps will have on those affected, we studied a representative sample of Medicare beneficiaries with naturally occurring prescription benefit gaps between 1998 and 2000 using data from the Medicare Current Beneficiary Survey. Our findings suggest that discontinuities in drug benefits result in sizable reductions in medication use and spending, which is magnified in people with common chronic illnesses.

Key Words: Business Of Health, Consumer Issues, Elderly, Health Reform, Insurance Coverage, Medicare, Pharmaceuticals, Health Spending

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