Medicare Part D and Changes in Prescription Drug Use and Cost Burden: National Estimates for the Medicare Population, 2000 to 2007
Department of Medicine, Division of Geriatric Medicine; Meyers Primary Care Institute
Medical Subject Headings
Insurance, Health, Reimbursement; Prescription Drugs; Cost Sharing; Medicare Part D
Geriatrics | Health Services Research | Primary Care
CONTEXT: The full effect of Medicare Part D, after the initial policy transition period and across the United States Medicare population, remains unclear.
OBJECTIVE: To estimate nationally representative changes in prescription drug use and out-of-pocket drug costs 2 years after implementation of Part D.
DESIGN, SETTING, AND PARTICIPANTS: We examined study outcomes over 8 years (2000 to 2007) and estimated changes after Part D, accounting for earlier trends. Our analyses used the community-dwelling sample of the Medicare Current Beneficiary Survey (unweighted unique n=38,798). Actual post-Part D outcomes were compared with projected values using 2000 to 2005 data. Subgroup analyses and standardization weights were used to address population-level shifts over time in health status and demographic characteristics.
MAIN OUTCOME MEASURES: Annual prescription drug fills and out-of-pocket drug costs.
RESULTS: We observed significant average per person increases of 1.8 prescription fills [95% confidence interval (CI), 1.1-2.5] in 2006 and 3.4 prescription fills (95% CI, 2.7-4.1) in 2007 above pre-Part D increases of 0.9 prescription fills per year. Average out-of-pocket drug costs decreased significantly by $143 (95% CI, -182.5--103.1) in 2006 and $148 (95% CI, -181.2--114.1) in 2007 above average pre-Part D increases of $12 per year. Prescription fills did not change for beneficiaries with fair to poor health until 2007 when large increases occurred (increases of 3.7 to 11.0 fills above pre-Part D trends). Significant reductions in OOP drug costs occurred in 2006 and persisted into 2007 across all groups except for sick and poor beneficiaries without Medicaid.
CONCLUSIONS: After the transition year of 2006, the impact of Part D seemed larger and more consistent across the Medicare population. Of note, sick and poor beneficiaries experienced significant improvements in prescription drug use in 2007.
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Citation: Med Care. 2011 Sep;49(9):834-41. Link to article on publisher's website
Briesacher, Becky A.; Zhao, Yanfang; Madden, Jeanne M.; Zhang, Fang; Adams, Alyce S.; Tjia, Jennifer; Ross-Degnan, Dennis; Gurwitz, Jerry H.; and Soumerai, Stephen B., "Medicare Part D and Changes in Prescription Drug Use and Cost Burden: National Estimates for the Medicare Population, 2000 to 2007" (2011). Meyers Primary Care Institute Publications and Presentations. 233.