Clouds on the Horizon, Part III

J0402448 Back on April 7, in the posting Clouds on the Horizon, Part I, I wrote about Medicare Part D and the impending donut hole.

For those of you who don’t remember, or are new to the blog, the donut hole is that part of the Medicare Part D benefit that few have yet encountered.  Unfortunately it is not glazed or powdered with sugar and something you can pop in your mouth with coffee, it is quite literally a hole in the program.  When the feds spend so much on your benefit, the benefit just stops for a while.  The senior citizen who has been enjoying the benefit, now has to go back to eating cat food or splitting meds to get by until they have spent a lot of their own money (assuming they have it) and then catastrophic care kicks in and covers them again.

But catastrophe kicks in sooner than that for pharmaceutical companies.  Yesterday there were pictures in the paper showing many fine members of Congress falling all over themselves with pleasure at the number of people who have signed up.  There have even been some cheerleader bloggers who keep extolling the virtues of the benefit.   Of course, because there was a gun aimed at the heads of seniors in the form of a penalty for not signing up, it makes sense that there was a rush to do so by the deadline.  Dr. McClellan, head of CMS, did not acknowledge that, nor the fact that the Administration has been a little fishy in their assessment of the numbers who have signed up.

But while all that self-congratulatory celebrating was occurring, hopefully pharmaceutical companies, both collectively and individually have been preparing for the day when large numbers of seniors hit the donut hole.  If not, here is a short list of what you should be doing:

  • Identify the resources available through your own patient assistance programs and through other routes to assist seniors through the donut hole.
  • Consider any modification to patient assistance programs that might help seniors through the donut hole.
  • Create on-line and written communications that will help steer people in the direction of help.
  • Develop your messaging architecture around what you are doing, and more importantly, what you are not doing, rather than leave it for the last minute.

Without good planning, the industry is in line for some of the blame when the senior hits the hole.  By acting proactively, relationships with senior citizens and image as a whole need not suffer as much as it might.

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