title: How end-stage renal disease patients manage the Medicare Part D coverage gap.
abstract: Medicare Part D was enacted to help elderly and disabled individuals pay for prescription drugs, but it was structured with a gap providing no coverage in 2010 between $2,830 and $6,440. Patients with end-stage renal disease (ESRD) are especially likely to be affected due to high costs of dialysis-related drugs and the importance of adherence for overall health. Researchers from social work, pharmacy, and dietetics interviewed 12 patients with ESRD to learn about strategies and challenges during the coverage gap. Constant comparison generated the following themes: the experience of hitting the gap, management strategies, physical and emotional consequences, and advice for others. Results suggest that patients could benefit from greater involvement with professionals and peers to prepare for and manage their medications during the coverage gap and for support in dealing with emotional consequences and stress related to financial pressures and living with a serious health condition.
authors.affiliation: School of Social Work, Virginia Commonwealth University, Richmond, VA 23284, USA. pjkovacs@vcu.edu
authors.forename: Pamela J
authors.initials: PJ
authors.lastname: Kovacs
authors.forename: Nathan
authors.initials: N
authors.lastname: Perkins
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Nuschke
authors.forename: Norman
authors.initials: N
authors.lastname: Carroll
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D019458:Insurance Coverage / Q000191:economics*; D007676:Kidney Failure, Chronic / Q000188:drug therapy / Q000191:economics*; D008297:Male; D054524:Medicare Part D / Q000191:economics*; D055118:Medication Adherence; D008875:Middle Aged; D011340:Problem Solving; D036301:Qualitative Research; D006435:Renal Dialysis / Q000191:economics*; D012947:Social Work; D014481:United States