Our Fair Share: Closing the Coverage Gap

Bloomberg takes a look at upcoming prescription medicine savings for Medicare patients in a story headlined “Drugmakers’ ‘Doughnut Hole’ Deal on Overhaul to Shave Sales Less Than 1%.”

Issues_logo The story concludes that the industry’s agreement to fill the coverage gap “may provide more than $2 billion in drug discounts to senior citizens” who fall in the coverage gap under the Medicare prescription drug benefit next year. It also notes that the savings represent just a small fraction of global sales of name-brand prescription medicines.

As the new health care law takes effect in the coming years, it will be useful to remember a few key points about the industry’s financial support for the law:

1. Biopharmaceutical companies will contribute about $100 billion over the next decade to help pay for the new law, which will provide health coverage for 32 million Americans.

2. As part of its support for health care reform legislation, the industry agreed to cut out-of-pocket costs on brand name medicines by 50 percent for Medicare patients who reach the coverage gap .

3. The coverage gap is just one way the industry is paying its fair share to fund the new health care law. For example, AstraZeneca and other companies will pay increased Medicaid rebates and an excise fee on sales to government programs.

Seniors are already seeing significant savings under the existing Medicare prescription drug benefit and are highly satisfied with the program.  On average, patients are saving $1,200 a year on their medicines, and qualifying low-income beneficiaries will save about $4,000 in 2011 – even before additional savings before health care reform, according to the Centers for Medicare and Medicaid Services.

Despite this success, AstraZeneca and others recognized the need to support strengthening an already strong program by reducing patients’ out-of-pocket expenses once they reach coverage gap – while also expanding access to affordable health insurance for millions of Americans.

Note: Medicare also offers these tips to help patients lower costs once they reach the coverage gap.

– By Tony Jewell