2010/08/09 by Christopher Millett · 8 citations
Medicine · Economics, Econometrics and Finance · #Medication Adherence and Compliance #Healthcare Policy and Management #Pharmaceutical Economics and Policy
paper · doi:10.1001/archinternmed.2010.208
BACKGROUND: Medicare Part D, introduced in January 2006, was intended to decrease beneficiaries' out-of-pocket expenditures on medications. METHODS: We examined whether this policy was successful in achieving this goal, including effects on Medicare beneficiaries without previous drug coverage and those who previously received coverage through Medicaid, in a longitudinal study of out-of-pocket expenditures on medications in 1504 Medicare beneficiaries 65 years and older participating in the 2005 and 2006 waves of the Medical Expenditure Panel Survey. RESULTS: Mean annual out-of-pocket expenditures on medications decreased by 32% (320; 95% confidence interval [CI], 250-391), from 1011 to 691, in the year after Part D was implemented for all Medicare beneficiaries in the Medical Expenditure Panel Survey. Mean annual out-of-pocket expenditures on medications decreased by 49% (748; 95% CI, 600-897), from 1533 to 784, in beneficiaries without previous drug coverage who enrolled in a Part D plan. Beneficiaries who did not enroll experienced a mean reduction of 32% (353; 95% CI, 188-518), from 1116 to 763. Mean annual out-of-pocket expenditures on medications remained similar in dual Medicare and Medicaid beneficiaries. CONCLUSIONS: The introduction of Medicare Part D was associated with reductions in Medicare beneficiaries' out-of-pocket expenditures on medications, particularly in beneficiaries without previous drug coverage, and did not substantially change expenditures for Medicare beneficiaries who previously received pharmacy coverage through Medicaid. However, a question remains about whether the high public cost of providing pharmacy coverage through Medicare is worth the substantially lower financial benefit derived by beneficiaries.