Drug benefit cap does not cut insurer costs

Research into the effects of prescription drug coverage caps in the USA finds that insurers costs are not cut, because the reduction in spending is offset by the cost of dealing with medical emergencies brought about by patients skipping doses of treatment.

The study was compiled by Kaiser Permanente, working with the University of California - San Francisco and Harvard University. Funding was provided by the Agency of Healthcare Research and Quality, the National Insitute on Aging and the Alfred P Sloan Foundation.

The cost of medical care and clinical outcomes for 199,179 Medicare beneficiaries enrolled on a Kaiser Medicare+ Choice plan in 2003. Of the enrollees, 41,904 did not have a coverage cap, the remaining 157,275 having a $1,000 annual cap. In both cases, patients were obliged to make co-payments of between $15-$30 for branded drugs and $10 for generics.