The Doughnut Hole: It's About Medication Adherence
Authors: Christianne L. Roumie
Journal: Annals of Internal Medicine (2012)

Editorials5 June 2012The Doughnut Hole: It's About Medication AdherenceChristianne L. Roumie, MD, MPHChristianne L. Roumie, MD, MPHFrom Veterans Affairs Tennessee Valley Healthcare System, Geriatrics Research and Education Center, and Vanderbilt University Institute of Medicine and Public Health, Nashville, TN 37212.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-156-11-201206050-00010 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail The Medicare Prescription Drug, Improvement, and Modernization Act went into effect on 1 January 2006. Part of this act was the creation of Medicare Part D, a federal program to subsidize the costs of prescription drugs for Medicare beneficiaries. In 2006, the plan required beneficiaries whose total annual drug costs exceeded $2250 to pay 100% of prescription costs until they spent $5100 on medications out of pocket and entered catastrophic coverage. This coverage gap is well-known among Medicare beneficiaries as the “doughnut hole.” Once the patient spent $5100 in annual out-of-pocket costs, the “hole” closed and all medication expenses above ...References1. Madden JM, Graves AJ, Ross-Degnan D, Briesacher BA, Soumerai SB. Cost-related medication nonadherence after implementation of Medicare Part D, 2006-2007. JAMA. 2009;302:1755-6. [PMID: 19861666] CrossrefMedlineGoogle Scholar2. Safran DG, Strollo MK, Guterman S, Li A, Rogers WH, Neuman P. Prescription coverage, use and spending before and after Part D implementation: a national longitudinal panel study. J Gen Intern Med. 2010;25:10-7. [PMID: 19882193] CrossrefMedlineGoogle Scholar3. Soumerai SB, Pierre-Jacques M, Zhang F, Ross-Degnan D, Adams AS, Gurwitz J, et al. 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Potential savings from substituting generic drugs for brand-name drugs: medical expenditure panel survey, 1997-2000. Ann Intern Med. 2005;142:891-7. [PMID: 15941695] LinkGoogle Scholar21. Asch SM, McGlynn EA, Hogan MM, Hayward RA, Shekelle P, Rubenstein L, et al. Comparison of quality of care for patients in the Veterans Health Administration and patients in a national sample. Ann Intern Med. 2004;141:938-45. [PMID: 15611491] LinkGoogle Scholar Author, Article, and Disclosure InformationAffiliations: From Veterans Affairs Tennessee Valley Healthcare System, Geriatrics Research and Education Center, and Vanderbilt University Institute of Medicine and Public Health, Nashville, TN 37212.Disclosures: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M12-0779.Corresponding Author: Christianne L. Roumie, MD, MPH, Nashville Veterans Affairs Medical Center, 1310 24th Avenue South, GRECC 4A120, Nashville, TN 37212; e-mail, christianne.[email protected]edu. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoEffect of the Medicare Part D Coverage Gap on Medication Use Among Patients With Hypertension and Hyperlipidemia Pengxiang Li , Sean McElligott , Henry Bergquist , J. Sanford Schwartz , and Jalpa A. Doshi Metrics Cited ByAssociation of Medication Adherence with Hospital Utilization and Costs Among Elderly with Diabetes Enrolled in a State Pharmaceutical Assistance ProgramThe Probability of A1C Goal Attainment in Patients With Uncontrolled Type 2 Diabetes in a Large Integrated Delivery System: A Prediction ModelAttitudes, Beliefs, and Cost-Related Medication Nonadherence Among Adults Aged 65 or Older With Chronic DiseasesCost savings impact of a pharmacist-initiated teleservice program for Medicare Part D reviewsThe Unifying Concept of Illness Behavior 5 June 2012Volume 156, Issue 11Page: 834-835KeywordsCardiovascular disease riskDrugsHospitalizationsHyperlipidemiaHypertensionMedicareMyocardial infarctionObservational studiesPharmacists ePublished: 5 June 2012 Issue Published: 5 June 2012 PDF DownloadLoading ...