this year should be the last in the donut whole as I’m withdrawing from all my meds…but I did just hit it again this month…and the withdrawal process is actually very expensive as I have to get multiple doses to taper very slowly.

As I said, there are planty of other sources. For instance:

“Just over 3 million Medicare beneficiaries were projected to have spending in the coverage gap in 2007, according to analysis by Actuarial Research Corporation for the Kaiser Family Foundation.”

Since there were roughly 25M enrollees, the percentage is about 12%. Is that good enough for you?

http://www.kff.org/medicare/upload/7044_08.pdf

Atlex

As noted in a previous posting, I agree that the ability to have “lock-in” pricing should be fixed and CMS is planning to do so. as fr not being able to afford meds while in the donut hole…have you applied for the LIS? Do you live in a state that has a program to help in the donut hole? Also, many of the major pharmaceutical companies have programs to assist patients in the donut hole.

Madpharma,

The WK report is incredibly flawed and only deals with very limited data. Moreover, it doesn’t properly account for dual and LIS enrollees.

Atlex

CMS needs to outlaw lock-in (spread) pricing. We need more transparency so Medicare enrollees don’t have to play this game to get honest pricing. Why isn’t the pharmacy community lobbying Congress to have this changed?

I’ve hit the donut hole each year since the programs inception. It’s screwed and shouldn’t be allowed to happen. I have no means to pay for the drugs myself.

A kind family member paid for me…there are too many who do not have kind family members with the means to dish out $3,000 bucks…

this is a travesty.

Please go read the article. It noted that 12% of all beneficiaries reported that they hit the donut hole. Other sources cite 13% to 15%. Separately, the article notes that only 14% of enrollees are in plans that use “lock-in” pricing. Thus, roughly 2% (14% x 15%) of beneficiaries are signficantly impacted by this practice.

Your lack of understanding of the benefit is astounding. The CMS numbers you cite are averages. They are skewed by the very high-cost beneficiaries who enter the catastrophic coverage (where they pay only 5% co-pay) and by the large segment of beneficiaries (dual eligibles and other low income subsidy enrollees) who don’t have a donut hole.

Atlex

Just as a point of reference, The Center for Medicare and Medicaid Services estimated that in 2006 the average Medicare Part D beneficiary spent $3080 a year on medications. That is $500 more than the donut hole which hits at $2516 so practically everyone hits the donut hole. The question for most Medicare participants is when do I hit it and how do I make it through the next $3k of drugs on my own so coverage picks back up.