Current Drug Shortages

Have you ever gone to a pharmacy to pick up your prescription just to be told that it is unavailable? How about noticing that blood pressure medication that you have taken for years is suddenly blue, then white, then green? All of this is due to national drug shortages. 

A full list of prescription drugs on shortage currently can be found  at:  http://www.fda.gov/drugs/drugsafety/drugshortages/ucm050792.htm and they are updated frequently. 

A few of the more notable shortages that you may notice from your neighborhood pharmacy are:

1. Cyanocobalamin Injection (Vitamin B12 shots)--listed as an increased in demand for the drug
2. Hydromorphone Tablets (Generic for Dilaudid)--listed as unknown reason 
3. Methylphenidate IR and ER Tablets (Generic for Ritalin)--listed as an increased in demand for the drug
4. Tetracycline Capsule--listed as shortage of active ingredient 

The list of drugs on national shortage is very long, though it mostly contains medications that affect you while you are in the hospital (such as IVs and injections). To check if any of your medications may be on the list, visit the link to the FDA website above. 

Common Questions on Medicare Part D

Q. What is Medicare Part D?

A. Congress approved the Medicare Modernization Act in 2003 to provide affordable prescription drugs to seniors and the disabled. It took effect in 2006. Some 36 million people are now enrolled in private insurance plans that pay most of the cost of their drugs. Medicare spent $62 billion subsidizing the program last year.

Q. Where does this data come from?

A. When pharmacies dispense prescriptions to Medicare patients, they transmit information to Part D plans about the patient, the prescriber, the drug, its strength and retail cost. The plans pay the claims and then submit the data to the Centers for Medicare and Medicaid Services, which oversees Medicare. ProPublica obtained and analyzed data for 2007-2011 for this project. We are currently displaying data for 2011 -- covering more than 1.1 billion prescriptions and refills. (We had previously displayed data for 2010; that information is no longer available.)

Q. Why is my health provider not in here?

A.  Medications administered to Medicare enrollees during an office visit or in a hospital are covered by another part of Medicare, not Part D. That means they will not show up in our data. In addition, providers who did not write at least 50 prescriptions (including refills) of at least one drug under Medicare Part D will not show up. Nearly 364,000 providers are reported on Prescriber Checkup.

To continue reading this article visit: http://www.dailymail.com/News/201311240074

The Truth About Flu Vaccines

Lately there has been a lot of talk about the safety and necessity of flu vaccines. I find myself reading articles on social media such as "11 Reasons Why Flu Shots Are More Dangerous Than The Flu Itself" posted on realfarmacy.com and cannot help but get frustrated. This article along with others suggest, without out reliable sources, that flu shots are in fact dangerous for the public--especially the elderly and young children Many parents are refusing to vaccinate their young children, who often end up suffering for days with the flu the picked up from daycare or school.

According to the Center for Disease Control (CDC), there have been 22,048 cases of the flu reported in the  2011-2012 flu season, which is a dramatic increase from the year before. This flu season is expected to follow that trend. Children and the elderly are at a particularly higher risk for contracting the flu, and are at an especially high risk for hospital admittance and death, due to the fact  that they have weakened immune systems.

Articles such as "11 Reasons Why Flu Shots Are More Dangerous Than The Flu Itself" suggest that the flu vaccine is unsafe for many reasons. One reason that they suggest it is unsafe is the level of mercury in the vaccines. Thiomerosal, a preservative used in most of the influenza vaccines has been greatly reduced over the years. There is also a preservative free version that is available for children and pregnant women that contains only trace amounts of thiomerosal. These trace levels have been review by the Institute of Medicine Immunization Safety Review Committee and found to be safe.

There have also been suggestions that those pushing flu vaccines are those making millions of dollars. This is partially correct. While the drug manufactures and the CDC may benefit--healthcare professionals such as pharmacists, nurses, and doctors do get "bonuses" because you get a flu shot. Most of us are encouraging you to get a flu shot because it is beneficial for you and those around you.

I have also heard or read from many friends and family that they work at institutions or facilities that require them to get a flu vaccine before they can work there--or they must wear a mask every day during flu season. This is often true of nursing homes, long term care facilities and hospitals. While these individuals state it is "their right to put whatever they want in their body," what needs to be considered is who they may be affecting on a daily basis. Most places with these policies in place house elderly, young, or those with otherwise weakened immune systems. Germs can be brought from home and introduced into the institution, which can be detrimental for a patient that is not strong enough to fight off an infection that a health 25 year old may be able to. So while it is your right to get a flu vaccine or not, it is also the patients right to be housed in a healthy environment.

CVS Caremark Predicts Specialty Drug Spending to Increase Exponentially

Where a drug is administered can significantly impact specialty pharmacy costs 
 
Management of the whole patient critical to improving outcomes, managing costs 
 

WOONSOCKET, R.I., Nov. 20, 2013 /PRNewswire/ -- A new CVS Caremark (NYSE: CVS) report released today projects that specialty drug spend is expected to more than quadruple by 2020, reaching approximately $402 billion a year. The Insights report on specialty pharmacy prescribing trends and strategies for managing costs also reports that while only a very small percentage of patients (less than four percent) use specialty medications, they account for 25 percent of health care costs. Specialty drugs treat complex diseases such as multiple sclerosis, rheumatoid arthritis, hepatitis C and cancer and represent a rapidly growing area of spending in health care.

(Logo: http://photos.prnewswire.com/prnh/20090226/NE75914LOGO )

"Specialty pharmacy trend is driven by price, mix and utilization, just like traditional drug trend, but managing specialty drug trend is more complex," said Jon Roberts, president of CVS Caremark's pharmacy benefit management business. "While many payors already have basic strategies in place to manage costs and ensure safe and effective use of specialty drugs, we have found that every plan has the opportunity to improve upon their management of this category."

The report reviews foundational strategies for managing specialty drug trend and provides additional insights into key areas where CVS Caremark offers expanded services to improve cost savings for clients. These areas include: understanding the cost impact resulting from the location of drug administration for infused drugs (e.g., at the hospital, doctor's office or at home), gaining visibility to the portion of specialty pharmacy spend billed under the medical benefit, and providing a full range of services designed to provide comprehensive care for the patient that can improve outcomes and reduce overall medical costs.

"Clinical appropriateness is the primary consideration when managing specialty pharmacy patients, but there are a variety of other factors that can also affect the optimal therapy choice for an individual," said Alan Lotvin, MD., executive vice president of Specialty Pharmacy at CVS Caremark. "For example, the site of care where an infused drug is administered to the patient is one area that can significantly impact costs for the patient and payor without necessarily influencing the patient's outcomes."

Understanding the Cost Impact of Site of Care

Many specialty drugs for the treatment of conditions such as cancer, rheumatoid arthritis and multiple sclerosis are administered via infusion that can take place in a hospital, physician's office, infusion center or even the patient's home. Costs for both the drug and its administration can vary by thousands of dollars depending on where the patient receives the infusion. CVS Caremark offers programs that can help payors increase the utilization of more cost-effective sites of care for infused therapies.

To continue reading this article visit: http://online.wsj.com/article/PR-CO-20131120-905858.html?dsk=y

Telehealth Improves Patient Relationships As Well As Sales

As this video shows, telehealth can be very beneficial to patients and providers when communication is difficult due to various barriers. Telehealth provides the option for counseling when it would otherwise be turned down as well as the ability to form a closer pharmacist-patient relationship. Patients often feel more comfortable calling their pharmacist with questions about side effects and clarifications when they feel that they know their providers personally. Telehealth is a communication method that is growing in the rural pharmacy setting, the mail-order pharmacy setting and the long term care facility setting.

Generic Drugs No Longer the Bargains They Once Were

Generic drugs are often thought of as bargains.  But in the last year, the prices of many generic medicines have skyrocketed and pharmacists across Vermont say they and their customers are taking a hit. Jason Hochebert is one of the owners of Rutland Pharmacy, a family-owned business with four locations. 

He says generic prices have been all over the place lately. He picks up a bottle of Digoxin for instance, a popular heart medicine. “Yeah,” says Hochberg, “without warning it went from under $100 for a bottle to over a couple hundred dollars a bottle. Creams are another one - nystatin creams and triamcinolone creams which are your generic steroid or anti fungal creams - they’ve also skyrocketed in price.”  He says, “they used to be like $1.69 for a small tube and now it’s 12 bucks. That may not seem like a lot on the grand scale, but that’s 1000%.”

Ken Wilkins of Mount Tabor stops in Hochberg’s pharmacy to pick up his medicine. “As a newly diagnosed diabetic, I have to take more drugs,” says Wilkins. “And it seems like they’re changing them all the time.  And it is an issue for someone who’s retired and on a fixed income.”

For patients on Medicare or with low deductible insurance, the price hikes may be less noticeable. But Jim Godfrey, President of the Vermont Pharmacists Association, says the situation has hit those without insurance hard. “When you’ve been paying $30 cash a month for meds and then all of a sudden it goes up ten fold, you’ve got a $300 a month medication all of a sudden - this can be a significant issue.”

He and other pharmacists say it’s frustrating because the price hikes seem so random.

But Robert Jaffe says there's nothing random about it.  Jaffe is a spokesman for Lannett Company, which makes and sells close to 80 different generic drugs.  In an email to VPR, Jaffe wrote that drug prices are affected by numerous market forces including the increase in cost for hard to find raw materials, new steps in the Food and Drug Administration product development process, as well as what he described as a dramatic increase in fees for submitting a generic drug application.

Rutland Pharmacy’s Jason Hochberg understands the economics, but he and other pharmacists complain that insurance reimbursements aren’t keeping up with the price increases.

To continue reading this article visit: http://digital.vpr.net/post/generic-meds-no-longer-bargain-say-pharmacists

Prescription Drug Monitoring Program May Save Lives

Lisa was still recovering from a nasty fall down a flight of stairs when she walked into Eugene Decker's family practice office in December 2012.

X-rays showed the 34-year-old Phillipsburg woman had suffered fractures to her neck and back. Decker said the injuries were so significant, they could have left Lisa paralyzed.

So when she said she was looking for medication to help ease the pain, Decker had no reason to doubt her.

"She had all the right reasons to have pain meds and I prescribed pain meds to her," Decker said. "I didn't know she was going to other doctors."

In fact, Decker was one of more than two dozen doctors Lisa had visited in Pennsylvania and New Jersey between October and December 2012. According to documents obtained by her family members, those visits translated into 660 tablets of various prescription pills.

All in a period of 54 days.

With prescription drug abuse on the rise, many doctors now face a delicate balancing act of trying to decipher between patients in legitimate need of medication and those, like Lisa, who may have an addiction. 

Many advocates, including Decker, say the answer may lie in making improvements to states' prescription monitoring programs while encouraging, or mandating, increased participation by health care professionals. 

Unfortunately, for some, it is already too late.

To continue reading this article visit: http://www.lehighvalleylive.com/warren-county/express-times/index.ssf/2013/11/advocates_say_increased_use_of.html

Colorado Study: Healthcare Premiums Will Skyrocket Next Year

Colorado employers will pay an average of 10.9 percent more for health insurance in 2014 than 2013, a dramatic upward climb after two consecutive years of reduced cost increases, according to a study from insurance benefits consultant Lockton Cos.

The reason for the price escalation is twofold, said Bill Lindsay, president of Lockton Benefit Group in Denver and author of the survey. First, prices on services such as hospital and prescription-drug costs will continue to rise as they have in past year, though at greater rates than predicted elsewhere in the country.

But that will combine next year with a new slew of mandates on minimum insurance benefits required by the Affordable Care Act, as well as a 2.25 percent federal tax on self-insured plans. Those two alone will combine to increase employer costs by at least 5.25 percent, Lindsay said.

“Health care costs are going up for all of the above reasons — hospital construction, pharmaceutical costs, the aging population,” Lindsay said. “But we know the ACA by itself is going to add to the cost.”

Such double-digit-percentage price increases were common for the first 11 years of the 21st century, but the increases fell to 9.4 percent in 2012 and 7.4 percent in 2013 in the Lockton survey. Health reform advocates trumpeted a provision of the federal bill that triggered government reviews for all premium hikes of more than 10 percent as a primary reason for the decline.

To continue reading this article visit: http://www.bizjournals.com/denver/news/2013/11/13/employer-health-care-costs-will-soar.html

Regulation of Drug Costs

SEATTLE (AP) — Britain does it. So do France, Germany and Canada. The only major industrialized country that doesn't regulate the cost of prescription drugs is America.

Here, prices reflect what the market will bear. That’s dictated largely by insurance carriers, which negotiate reimbursements, and Medicare, which pays for essential treatment no matter the cost.

Sometimes, those prices stun. Soliris, an Alexion Pharmaceuticals drug used for a rare anemia, costs up to $440,000 a year. Gattex, a short-bowel-syndrome drug from NPS Pharmaceuticals, came out at $295,000 — three times the price first floated. Both drugs are licensed for only a few thousand U.S. patients each year.

Typically, the mega-blockbusters are orphan drugs licensed for multiple disorders, expanding the patient pool. A celebrated example is botulinum toxin type A, known today as wrinkle-remover Botox. Licensed in 1989 as an orphan drug to treat uncontrolled eye blinking, it generated $1.8 billion in sales last year.

The pharmaceutical industry says high prices offset costs of research, which can take years and cost a billion dollars or more. The winners help support the many losers, subsidizing the chase for new drugs, according to industry trade groups.

A Thomson Reuters industry report published last year noted that more pharmaceutical companies are entering the rare-disease market because profit margins often exceed those for non-orphan drugs.

To read more about this article visit: http://www.trivalleycentral.com/trivalley_dispatch/health_and_wellness/most-countries-regulate-drug-costs/article_58aff816-4bdb-11e3-ba6a-0019bb2963f4.html

Pediatric ER Visits From OTC Cough Medicine on the Decline

A new study, "Cough and Cold Medication Adverse Events After Market Withdrawal and Labeling Revision," shows that emergency department visits associated with over-the-counter (OTC) pediatric cough cold medicines in children age 3 and younger have declined following voluntary industry labeling initiatives specifically designed to improve safe use in this age. Conducted by researchers at the Centers for Disease Control and Prevention (CDC) and published today in the journal "Pediatrics," the study notes that unsupervised ingestions - curious young children getting in to medicines that were left within reach - drove the vast majority of the few adverse events in young children.

Manufacturers voluntarily withdrew OTC infant cough and cold medications in 2007 to curtail unsupervised ingestions in this young population. A year later, in conversation with the Food and Drug Administration (FDA), manufacturers relabeled these products only for use in children age 4 and older and initiated ongoing educational efforts to reinforce age-appropriate safe use and safe storage.

"The data show what we know to be true: Education and proactive efforts to help parents appropriately use over-the-counter pediatric cough and cold medicines are working," said Barbara Kochanowski, Ph.D., vice president of scientific and regulatory affairs at the Consumer Healthcare Products Association (CHPA). "Through education and packaging and labeling improvements, manufacturers are helping parents choose the right medicine, use the right medicine, and store medicine appropriately to avoid accidental, unsupervised ingestion—the primary cause of the rare reported adverse events involving these medicines."

To continue reading this article visit: http://www.news-medical.net/news/20131112/ED-visits-associated-with-OTC-pediatric-cough-cold-medicines-in-children-decline.aspx

FDA Beginning to Crack Down on Prescription Narcotics

The deadliest drug problem in America is not heroin or cocaine or even crack cocaine. It's the abuse of perfectly legal prescription pain medications — familiar names such as Vicodin and Lortab and generic hydrocodone.

Last month, federal regulators finally got around to recommending stronger restrictions on access to these medications by limiting refills and mandating more frequent visits to doctors to obtain prescriptions. Now doctors, who helped create the problem, need to do their share to control it.

Fourteen years have passed since Ronald Dougherty, a doctor and addiction specialist, noticed something odd at his clinic in suburban Syracuse, N.Y.: More patients were addicted to legal drugs than to illegal narcotics. He petitioned the federal government to treat these drugs as the growing danger they were.

Dougherty, it turned out, was as prescient as the federal government was sluggish. Since 1999, overdose deaths from narcotic painkillers in the U.S. have quadrupled. Every day, they kill 45 people and send 1,370 to emergency rooms. By contrast, cocaine kills 12 people a day and heroin kills eight.

One addictive painkiller, hydrocodone, is the most prescribed medication in America — 4 billion prescriptions a year at last count. Dr. Tom Frieden, director of the Centers for Disease Control and Prevention, said "doctors caused" this epidemic. "We're prescribing massive amounts of opiates," he told us last week, "and patients are getting hooked."

To read more visit: http://www.usatoday.com/story/opinion/2013/11/10/painkillers-prescription-drug-hydrocodone-fda-editorials-debates/3490545/

Government is Lowering Healthcare Costs By Raising Premiums

If regulators seem confused about how to implement a health care program as vast and sweeping as ObamaCare, maybe, just maybe, it's because they know how badly they've bungled smaller and simpler health care reform efforts -- especially a particular drug discount program.

Prior to 1990, many drug manufacturers voluntarily discounted their drugs to hospitals and clinics that serve disproportionately poor and uninsured populations. Then Washington was seized with a good intention -- and you know which roads are paved with them.

Congress passed a law in 1990 mandating that pharmaceutical companies selling drugs through Medicaid -- a government health insurance program for the poor -- give the program the "best price" available.

That requirement had a major unintended consequence: Drug companies could no longer deeply discount prices to those organizations serving vulnerable patient populations because, by law, Medicaid had to get the lowest price.

As a result, many firms simply stopped providing those voluntary price discounts.

So, in 1992 lawmakers were struck with another good intention and created a program known as "340B" to reverse the negative impact of their last good intention. The law required pharmaceutical firms to do what they once did voluntarily -- offer steep discounts on certain outpatient drugs, such as cancer drugs, to entities that treated vulnerable patient populations.

Those lawmakers initially expected about 90 U.S. hospitals to qualify. By 2011, 1,675 hospitals participated in 340B. And the reason is more about profit than helping the poor.

Qualifying hospitals and clinics buy all of their 340B medications at a 25 to 50 percent discount, whether they're dispensed to poor people or not. Hospitals then bill the insurance company at the full price, plus a mark-up.

Read more:http://www.gilmermirror.com/view/full_story/23983829/article-Congress-Tries-to-Lower-Drug-Costs-and-Raises-Health-Insurance-Premiums-Instead?instance=news_special_coverage_right_column

Are Pain Medications Safe for Pets?

Your 9-year-old German Shepherd is limping, and you think that arthritis may be setting in. A trip to the veterinarian proves that you’re right—it’s osteoarthritis, a degeneration of the cartilage and bone that affects joints. The veterinarian prescribes a non-steroidal anti-inflammatory drug (NSAID).

NSAIDs are a class of drugs extensively used in both human and veterinary medicine for their anti-fever, anti-inflammatory and pain-relieving properties, and they are the most commonly prescribed pain relievers for animals. Inflammation—the body’s response to irritation or injury—is characterized by redness, warmth, swelling, and pain. NSAIDs work by blocking the production of chemicals produced by the body that play a role in inflammation.

“Scientists consider NSAIDs the cornerstone of osteoarthritis therapy in dogs,” says Melanie McLean, D.V.M., a veterinarian at the Food and Drug Administration (FDA). Some NSAIDS are also used to manage pain after surgery in both dogs and cats. No NSAID has been approved for long-term use in cats.

NSAIDs carry risks as well as benefits, however, and all dogs and cats should undergo a thorough physical examination by a veterinarian—including a discussion of the pet’s medical history— before beginning NSAID therapy. McLean notes that it’s also important that you talk to your veterinarian about possible side effects, including those that could signal danger.

NSAIDS are associated with gastrointestinal ulcers/perforations, kidney, and liver toxicity (damage done by exposure to medications or chemicals) and must be used cautiously in animals with pre-existing kidney or liver problems.

Because most liver-associated toxicities occur during the first three weeks, it’s especially important to closely monitor the results of blood tests during the early stages of long-term NSAID treatment in dogs. Also, before starting long-term treatment with NSAIDs in dogs, blood tests should be conducted to establish baseline data and then repeated on a regular basis. McLean recommends that you talk with your veterinarian about how often this blood work should be done.

Some of the most common side effects of NSAIDS in animals reported to FDA are:

• vomiting
• decreased to no appetite
• decreased activity level
• diarrhea

To continue reading this article visit http://www.fda.gov/ForConsumers/ConsumerUpdates/ucm373009.htm

Educating Tweens On Over the Counter Medication Use

The American Association of Poison Control Centers (AAPCC), together with Scholastic, the global children's publishing, education and media company, are continuing their commitment to help educate "tweens" on the safe use of over-the-counter (OTC) medicines with their expanded OTC Literacy classroom program. Research shows that tweens begin to self-administer medicine around 11 years old, or around 5th or 6th grade. With cold and flu season in full swing, it is a good time for parents and guardians of tweens to teach their children about OTC medicine safety.

The OTC Literacy program, which launched earlier this year in schools nationwide, now includes new resources and engaging educational activities specifically designed for parents and teachers of tweens to increase knowledge of OTC safety and responsible use. Education about OTC medications, such as how to read a Drug Facts label, is critical -- giving tweens the knowledge they need to become responsible adults who follow label instructions for OTC medications. The program places special emphasis on the message that tweens should only take OTC medications with the permission and supervision of parents or guardians. Educators and parents can also download all of the materials online at www.scholastic.com/OTCliteracy/parents.

"It's important for tweens to learn about OTC medication safety, including how to read directions, follow dosing guidelines, properly measure medication, store medications out of reach of younger siblings and to always consult a parent or trusted adult prior to taking any medication," says Tanya Altmann, M.D., F.A.A.P., a pediatrician and child health expert trained at the University of California, Los Angeles who is facilitating dialogue with parents about the need for more awareness regarding OTC Literacy among tweens. "Tweens also must understand that OTC medication is often helpful when taken at appropriate doses, but can be extremely dangerous if taken incorrectly, in excess or too often."

The OTC Literacy program features new resources that are specifically designed to help facilitate conversations and provide learning opportunities for tweens. These materials include: an illustrated digital story, a digital student assessment quiz, a "Home Hazards Hunt" flash game and many other tools that can be used at home or in the classroom. Most of the family resources and tools are available in both English and Spanish.

To continue reading this article, visit: http://www.marketwatch.com/story/the-american-association-of-poison-control-centers-and-scholastic-expand-collaboration-to-educate-tweens-on-over-the-counter-medicine-safety-2013-11-04?reflink=MW_news_stmp

Prescription Opiod Epidemic

There has been what appears to be an epidemic rise in the abuse of opioid analgesics. Drug abusers are using their physicians to get prescriptions for these drugs and they are getting them in large supplies on the black market. Opioid analgesics are dangerous drugs which have been shown in recent research to set off depressive episodes and which are associated with many premature deaths. Every segment of the society has been hit with this problem, including the nations highly vulnerable students.

The Centers for Disease Control and Prevention writes that the abuse of prescription drugs is growing at a dramatic rate across the United States. Opioid analgesics have lead the list of drugs responsible for drug overdose deaths. Over-prescribing of these drugs by physicians is a critical problem. However, among persons who died of opioid overdoses, a significant proportion got them off the streets. Reporting on the critical problem of abuse of these drugs among our youth, EmaxHealth reporter Robin Wulffson MD has written that teens are responsible for much prescription drug abuse.

Opioid analgesics are associated with increased risk for depression

The Journal of General Internal Medicine has reviewed research showing prescription opioid analgesics are associated with an increase in the risk of depression. In this study it was found as the length of opioid prescription increased the risk of depression increased significantly. This risk for a depressive effect from these drugs should be more carefully considered by physicians and patients alike.

To continue reading this article visit http://www.emaxhealth.com/11402/prescription-opioid-analgesics-are-depressants-and-killers

Does the ACA really benefit Medicare Beneficiaries?

You wouldn't know it from reading the major dailies, since they have widely failed to report it, but while Congress wrestles over partisan talking points over whether online healthcare exchanges have been successful or not since they first launched on Oct. 1, The Centers for Medicare & Medicaid Services reported Monday that health care reform efforts at the center of the political storm in Washington are producing out-of-pocket savings for Medicare beneficiaries across the nation of more than $8 billion in cumulative savings in the prescription drug coverage gap known as the "donut hole."

Big savings on drug costs

According to CMS, since the Affordable Care Act provision to close the prescription drug donut hole took effect, more than 7.1 million seniors and people with disabilities who reached the donut hole have saved $8.3 billion on their prescription drugs. In the first nine months of 2013 nearly 2.8 million people nationwide who reached the donut hole this year have saved $2.3 billion, an average of $834 per beneficiary. These figures are higher than at this point last year (2.3 million beneficiaries had saved $1.5 billion for an average of $657 per beneficiary).

CMS also reported that there will be no growth in 2014 Medicare Part B premiums and deductibles compared to last year. Bending the cost curve has been a fundamental in the design of the Affordable Care Act. Reducing the rate of growth is a long term goal, but short-term cost containment is necessary in the overall discussion about deficits and debt.

The health care law gave those who reached the donut hole in 2010 a one-time $250 check, then began phasing in discounts and coverage for brand-name and generic prescription drugs beginning in 2011, CBS said in a media release. The Affordable Care Act will provide additional savings each year until the coverage gap is closed in 2020, it said.

To continue reading this article visit: http://www.examiner.com/article/cms-reports-aca-shrinks-donut-hole-8b-2014-part-b-costs-remain-unchanged