Despite advice from the Centers for Medicare and Medicaid Services to switch to less-expensive versions of their current medications, patients discontinued one or more prescriptions for essential drugs a year, according to a study in the current issue of PLoS Medicine, an open-access, peer-reviewed medical journal.

Researchers followed 663,850 Medicare beneficiaries enrolled in Part D or retiree drug plans and found that a lack of financial assistance after reaching the Part D coverage gap was associated with a doubling in discontinuing essential medications. The authors believe this could result in an additional 18,000 patients discontinuing one or more prescriptions for essential drugs a year—a 100% increase—and others to not take their required medications regularly.

"In contrast to blunt cost-sharing approaches such as the coverage gap feature, more nuanced, clinically informed insurance strategies that specifically promote the use of drugs with high benefit and low cost may hold the most promise for governments and insurers seeking to improve the health of their citizens while reining in drug costs," the authors conclude.