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Effects of Transitioning to Medicare Part D on Access to Drugs for Medical Conditions among Dual Enrollees with Cancer
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12 2017
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Source: Value Health. 20(10):1345-1354
Details:
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Alternative Title:Value Health
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Personal Author:
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Description:Objective
To evaluate the impact of transitioning from Medicaid to Medicare Part D drug coverage on use of non-cancer treatments among dual enrollees with cancer.
Methods
We leveraged a representative 5% national sample of all fee-for-service dual enrollees in the U.S. (2004–2007) to evaluate the impact of the removal of caps on the number of reimbursable prescriptions per month (drug caps) under Part D on (1) prevalence and (2) average days’ supply dispensed for antidepressants, antihypertensives, and lipid-lowering agents overall and by race (white, black).
Results
The removal of drug caps was associated with increased use of lipid-lowering medications (days’ supply: 3.63; 95% CI: 1.57, 5.70). Among blacks in capped states, we observed increased use of lipid-lowering therapy (any use: 0.08 percentage points; 95% CI: 0.05, 0.10; days’ supply: 4.01; 95% CI: 2.92, 5.09), antidepressants (days’ supply: 2.20; 95% CI: 0.61, 3.78) and increasing trends in antihypertensive use (any use: 0.01 percentage points; 95% 0.004, 0.01; days supply: 1.83; 95% CI: 1.25, 2.41). The white-black gap in use of lipid-lowering medications was immediately reduced (−0.09 percentage points; 95% CI: −0.15, −0.04). We also observed a reversal in trends toward widening white-black differences in antihypertensive (level: −0.08 percentage points; 95% CI: −0.12, −0.05; trend: −0.01 percentage points; −0.02, −0.01), and antidepressant use (−0.004; 95% CI: −0.01, −0.0004).
Conclusions
Our findings suggest that the removal of drug caps under Part D had a modest impact on treatment of hypercholesterolemia overall and may have reduced white-black gaps in use of lipid-lowering and antidepressant therapies.
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Source:
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Pubmed ID:29241894
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Pubmed Central ID:PMC5734096
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Document Type:
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Funding:
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Volume:20
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Issue:10
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[PDF-291.38 KB]
