One of the most puzzling parts of the Medicare Part D drug benefit is the gap in coverage—called the “doughnut hole.”

It is not up to us to try to explain it because, if it is altered, no more brain time need be spent on this.

However, seniors consume the most medications and, usually, the most medications per person.  The kinds of medications they need are more likely to be among the most expensive medications, cutting edge new drugs to combat chronic problems such as heart disease, diabetes and a range of other illnesses which advance over the patient’s life-time.

Any agreement which significantly reduces the dollars needed for medications is key to getting a health care reform plan passed which works and is acceptable to the greatest number of stake-holders: patients, yes, but doctors,  Big Pharma, state and federal governments—-to name some of the bigger ones.

MSNBC

“The pharmaceutical industry agreed Saturday to spend $80 billion over the next decade improving drug benefits for seniors on Medicare and defraying the cost of President Barack Obama’s health care legislation, capping secretive negotiations with the White House and key lawmakers.

“The deal, expected to be announced later in the day, marked a major triumph for Sen. Max Baucus, D-Mont., as well as the administration. The chairman of the Senate Finance Committee has been negotiating with numerous industry groups for weeks as he tries to draft legislation that meets Obama’s goal of vastly expanding health coverage, has bipartisan support and does not add to the deficit.

“Under the deal, which several officials confirmed, drug companies would pay as much as half of the cost of brand-name drugs for lower and middle-income seniors in the so-called doughnut hole — a gap in coverage that is a feature of many of the plans providing prescription coverage under Medicare.” (Emphasis added)

Source: MSNBC, June 20, 2009