Mental health patients face high Medicare Rx drug benefit costs

Elderly people with mental health problems who enroll into the US Medicare Part D prescription drug benefit are likely to spend as much as four times the out-of-pocket costs that are associated with private insurance, according to a new study. On average, they will reach the infamous "Donut Hole" (Marketletters passim; and see page 13), the gap in coverage between $2,250 and $5,100 of drug costs, up to two months earlier than other categories of prescription drug beneficiaries.

The research was carried out by a partnership between the National Institute of Mental Health in Bethesda, Maryland, USA, and Thomson Medstat, an Ann Arbor, Michigan, USA-based health care business analyst, and presented at the 11th annual international meeting of the International Society for Pharmacoeconomics & Outcomes Research.

The out-of-pocket costs for 1,114,009 Medicare Part D beneficiaires were examined by researchers, who found that, on average, patients with schizophrenia would spend $2,453 per year, compared with $596 per year for employer-sponsored coverage plans, a gap of 76%. For depression and anxiety, the corresponding figures were $2,181 versus $694 (a 68% gap) and $1,884 vs $659 (a 65% gap), respectively.