'Doughnut hole' gap's impact on adherence spells opportunity for community pharmacy

WHAT IT MEANS AND WHY IT'S IMPORTANT — The study's findings that the Part D coverage gap — or “doughnut hole” — led to a significant gap in the adherence of cardiovascular medications may not come as a complete surprise; however, it undoubtedly underscores the important role that pharmacy can play in helping patients navigate plan strategies that promote the use of lower-cost medications.

(THE NEWS: Study unveils drop in adherence to cardiovascular meds during 'doughnut hole' gap. For the full story, click here.)

As the article states, Medicare Part D beneficiaries with cardiovascular conditions who had no financial assistance during the "doughnut hole" coverage gap were 57% more likely to discontinue their cardiovascular medications than those beneficiaries who had consistent drug coverage.

That is a significant drop, and it is especially alarming when you look at some of the stats. According to the Centers for Disease Control and Prevention, heart disease is the leading cause of death for both men and women. In 2008, more than 616,000 people died of heart disease; it caused almost 25% of deaths — almost 1-in-4 — in the United States. Furthermore, the agency stated that, in 2010, coronary heart disease alone was projected to cost the United States $108.9 billion. This total includes the cost of healthcare services, medications and lost productivity.

The study’s research team noted that cardiovascular drugs accounted for the largest proportion of spending (25%) and prescription volume (36%) in the Part D program.

While the study found no increase in short-term negative health issues during the coverage gap, the long-term health impact of nonadherence to cardiovascular drugs during the coverage gap is unclear, according to researchers. OK, the long-term health impact may not be clear — at this point — but it is hard to imagine that a lack of adherence would lead to a positive outcome. After all, it is well-known that annual excess healthcare costs, because of medication nonadherence, in the United States are estimated to be as much as $300 billion annually.

Clearly, helping patients with plan strategies that promote the use of lower-cost medications is critical and is yet one more way in which community pharmacy can help patients live healthier lives.