Medicare Part D "donut hole" coverage gap affects adherence in cardiovascular patients, study finds

Medicare Part D beneficiaries with cardiovascular conditions who had no financial assistance during the “donut hole” coverage gap were 57% more likely to discontinue their medications than beneficiaries with consistent drug coverage, according to a new study.

Published in the April 17, 2012, issue of the journal Circulation: Cardiovascular Quality and Outcomes, the study was conducted by Brigham and Women’s Hospital in Boston and CVS Caremark.

“Consistent with other research on the impact of the Medicare Part D coverage gap on medication adherence, we found that exposure to 100% of drug costs in the gap led to abrupt discontinuation of essential cardiovascular medications,” said Jennifer M. Polinski, ScD, MPH, with the Division of Pharmacoepidemiology and Pharmacoeconomics at Brigham and Women’s Hospital and Harvard Medical School, lead author of the study.

The researchers followed 122,255 Medicare beneficiaries with cardiovascular conditions with linked prescription and medical claims who reached the coverage gap spending threshold in 2006 or 2007.

The study results did not demonstrate any short-term health issues as a result of the dramatic drop-off in medication adherence, according to Polinski, but the long-term effects are not clear. There were no significant differences in rates of death or other outcomes.