The Families USA report claims to demonstrate that fewer seniors will have to stand alone drug plans that offer meaningful coverage through the doughnut hole. In fact, the report either deliberately ignores or fails to acknowledge a fundamental shift in the design of stand-alone plans for 2007. Namely, lower out of pocket spending for a larger number of medicines for seniors. And the number of plans who offer such an approach has actually doubled from last year.
Most plans actually fill the doughnut hole and eliminate the coverage gap before it even starts by encouraging seniors to use generic medicines instead of brand drugs when available. In turn, most plans have added more drugs to their formularies and kept co-pays for newer medicines low. As a result, more seniors – most of whom never had drug coverage before – will have a wider choice of drugs and lower out of pocket expenses.
Ironically, for all its concern about providing seniors with meaningful doughnut hole coverage the FUSA proposal to use the VA system of price controls and drug formularies would create another kind of drug donught hole. It would create a gap in essential medicines. Only 38% of the drugs approved in the 1990s, and 19% of the drugs approved by the FDA since 2000, are on the VA National Formulary. Only 22% (17) of the 77 priority-review drugs approved since 1997 are on the 2005 National Formulary. By comparison, 100 percent of both types of FDA approved medicines are on the AARP Medicare formulary.
Most plans actually fill the doughnut hole and eliminate the coverage gap before it even starts by encouraging seniors to use generic medicines instead of brand drugs when available. In turn, most plans have added more drugs to their formularies and kept co-pays for newer medicines low. As a result, more seniors – most of whom never had drug coverage before – will have a wider choice of drugs and lower out of pocket expenses.
Ironically, for all its concern about providing seniors with meaningful doughnut hole coverage the FUSA proposal to use the VA system of price controls and drug formularies would create another kind of drug donught hole. It would create a gap in essential medicines. Only 38% of the drugs approved in the 1990s, and 19% of the drugs approved by the FDA since 2000, are on the VA National Formulary. Only 22% (17) of the 77 priority-review drugs approved since 1997 are on the 2005 National Formulary. By comparison, 100 percent of both types of FDA approved medicines are on the AARP Medicare formulary.
