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AARP Ramps Up Effort to Close Medicare Doughnut Hole

CHARLESTON—AARP’s Health Action Now campaign turns its attention to the growing problem of prescription drug costs and reducing the gap in prescription drug coverage for people in Medicare.  Closing the Part D doughnut hole could save people in the program thousands of dollars in drug costs and keep them healthier by ensuring they can afford their medications.

The Association is pressing lawmakers to lower individuals’ drug costs as a part of health reform, including closing the doughnut hole—which forces 28 percent of West Virginians in Medicare to pay their full drug costs each year—and increasing the availability of generic drugs, particularly generic versions of costly biologics.

“Prescription drug coverage has literally been a life-saver for people in Medicare, but the widening doughnut hole is still leaving too many Americans on their own to face skyrocketing drug costs,” said Gaylene Miller, Interim State Director for AARP West Virginia. “We know that higher costs lead people to skip doses or give up their prescriptions entirely, putting their health in jeopardy and driving up long-term costs.”

AARP is working with leaders on Capitol Hill to close the doughnut hole, which is predicted to top $6,000 by 2016.  Today, 3.4 million people fall into the gap each year, while only 15 percent of those are able to get out and receive catastrophic coverage.

AARP is also fighting to bring more generic drugs to market, particularly generic versions of costly biologic drugs used to treat diseases like cancer and multiple sclerosis. Unlike traditional chemical drugs, biologics are created from living organisms and have no FDA approval process for generic versions. Without generic competition, biologic makers are free to charge thousands of dollars per month, even for drugs that have been on the market for many years.

Miller added, “Since the 1980s, safe, affordable generic drugs have helped Americans save billions of dollars on their health care bills. With biologics now making up a large and growing share of the market, it’s time to bring those same savings to people taking these breakthrough drugs while protecting medical innovation.”

AARP has endorsed the “Promoting Innovation and Access to Life-Saving Medicine Act” (H.R. 1427/S. 726), which would create an FDA approval process—similar to that for traditional prescription drugs—for generic biologic drugs.

In addition, AARP is working to help the four million low-income Americans who are eligible for the Medicare Part D Low-Income Subsidy, which greatly reduces a person’s drug costs and has no gap in coverage.  The Association is fighting to increase access to the benefit by raising and ultimately eliminating the asset limit, expanding eligibility, standardizing eligibility rules, and raising awareness about the program.

AARP’s new fact sheet, “Closing a Gap in Medicare Drug Coverage,” details how the doughnut hole affects people in Medicare Part D and includes data on the number of people who reach the doughnut hole in each state.  

For details on AARP’s health reform priorities, visit http://www.aarp.org/governmentwatch.

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