Individuals with mental illnesses spend four times more out of pocket for prescription drugs under Part D than they typically would under employer–sponsored drug coverage, says a new study by Thomson Medstat sponsored by the National Institute of Mental Health.

Analyzing drug–spending data on 1,114,009 people with Medicare with retiree drug coverage in 2004, researchers found that mental illness significantly increases the amount spent annually on prescription drugs. In addition, mental health patients with Medicare reach the "doughnut hole" –the gap in coverage in which enrollees must bear the full cost of prescriptions–on average two months earlier than other people with Medicare. Half of schizophrenia patients are estimated to reach the doughnut hole by June 1; half of those with depression will reach the coverage gap by June 21.

The study, presented at the International Society for Pharmacoeconomics & Outcomes Research (ISPOR) 11th Annual International Meeting, highlights the differences in out–of–pocket expenses for three mental illnesses.

Patients with schizophrenia spend $2,453 on medications annually under Part D, compared with $596 for patients with employer–sponsored health insurance. For patients with depression, Part D enrollees spend $2,181 a year, versus $694 for patients with employer-sponsored coverage. And patients diagnosed with anxiety pay $1,884 annually under Part D, while patients with employer–sponsored coverage spend $659.

The study notes that a significant factor in the higher drug costs for individuals with mental illnesses is that mental health and physical health problems may compound each other. As a result, patients with mental illnesses likely require more prescription drugs.

(reproduced with permission from Medicare Watch, Issue 14)