The Impact of Medicare Part D on Out-of-Pocket Costs for Prescription Drugs, Medication Utilization, Health Resource Utilization, and Preference-Based Health Utility

2011/05/24 by Frank Xiaoqing Liu, G. Caleb Alexander, Stephanie Y. Crawford +3 · 16 citations
Medicine · Economics, Econometrics and Finance · #Medication Adherence and Compliance #Health Systems, Economic Evaluations, Quality of Life #Pharmaceutical Practices and Patient Outcomes

paper · pdf · doi:10.1111/j.1475-6773.2011.01273.x

Abstract

OBJECTIVES: To quantify the impact of Medicare Part D eligibility on medication utilization, emergency department use, hospitalization, and preference-based health utility among civilian noninstitutionalized Medicare beneficiaries. STUDY DESIGN: Difference-in-differences analyses were used to estimate the effects of Part D eligibility on health outcomes by comparing a 12-month period before and after Part D implementation using the Medical Expenditure Panel Survey. Models adjusted for sociodemographic characteristics and health status and compared Medicare beneficiaries aged 65 and older with near elderly aged 55-63 years old. PRINCIPAL FINDINGS: Five hundred and fifty-six elderly and 549 near elderly were included. After adjustment, Part D was associated with a U.S.179.86 (p=.034) reduction in out-of-pocket costs and an increase of 2.05 prescriptions (p=.081) per patient year. The associations between Part D and emergency department use, hospitalizations, and preference-based health utility did not suggest cost offsets and were not statistically significant. CONCLUSIONS: Although there was a substantial reduction in out-of-pocket costs and a moderate increase in medication utilization among Medicare beneficiaries during the first year after Part D, there was no evidence of improvement in emergency department use, hospitalizations, or preference-based health utility for those eligible for Part D during its first year of implementation.

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