Drug Makers Attempt To Fill Medicare Drug Doughnut Hole
A coalition of drug manufacturers is working on a plan to help millions of low-income seniors to pay for drugs when they enter Medicare’s so called “Doughnut Hole.” The Doughnut Hole is the coverage gap when a beneficiaries is responsible for drug costs when their total is between $2,250 and $5,000 annually.
The government has warned that a plan like this could be construed in violation of federal anti-kickback laws. The drug coalition has named their plan “Bridge Rx.”
Under the plan drug companies would offer discounts of at least 50% when low-income seniors hit the coverage gap. Those in the program would have a co-pay of $15. An amount still well above the means of a low-income beneficiary who likely is prescribed multiple drugs each month.
With only seven drug companies participating to date, they risk using discounts to steer beneficiaries to their drugs by using discounts, a violation of the federal anti-kickback laws.
The Kaiser Family Foundation estimates that 6.9 million beneficiaries will hit the coverage gap in 2006. The Bridge Rx coalition estimates that there could be as many as 500,000 participants in the program costing $30 million in the first year.
A formal response from the OIG on this plan is expected by Mid-February.
