GENERICS CAN DELAY MEDICARE GAP, PCMA SAYS

Seniors could enjoy several more weeks or even months of drug cost coverage under Medicare by using generic instead of brand drugs, according to a new report by the Pharmaceutical Benefit Care Association (PCMA).

Drug costs for Medicare recipients 65 or older are partially covered by the program's Part D drug benefit. Once beneficiaries' prescription drug costs have reached $2,250, they become responsible for 100 percent of the costs. Part D coverage kicks back in after they have spent a total of $3,600 in out-of-pocket expenses. PCMA notes that a report issued by the Centers for Medicare & Medicaid Services in August estimates 28 percent of Medicare recipients receive their Part D drug coverage through plans that have the so-called "doughnut hole" coverage gap.

By using generics, recipients can spend less on their drugs and delay or avoid reaching the coverage gap. Beneficiaries could also save an average of $1,200 on out-of-pocket drug costs, according to the report issued Sept. 7.

The study looked at four national Medicare prescription drug plans that collectively cover more than 50 percent of all Part D plan beneficiaries, and estimated costs of treating five primary conditions -- high-blood pressure, diabetes, heart disease, chronic obstructive pulmonary disease (COPD) and Alzheimer's Disease -- and assorted related conditions.

According to the report, recipients using a combination of generic drugs and mail-order pharmacies could get 13 more days of coverage for Alzheimer's disease, 61 more days of coverage for high-blood pressure, 65 additional days of coverage for COPD and 157 extra days of coverage for diabetes.

Patients with heart disease could receive an additional 76 days of Part D coverage and avoid falling into the coverage gap altogether, the report said.

The report can be found at: www.pcmanet.org/newsroom/2006/pr_09_06/9.07.06.htm (http://www.pcmanet.org/newsroom/2006/pr_09_06/9.07.06.htm).