Implementation of medicare part D and nondrug medical spending for elderly adults with limited prior drug coverage

JAMA

Volumn 306, Issue 4, 2011, Pages 402-409

  McWilliams, J Michael ^a,b   Zaslavsky, Alan M ^a   Huskamp, Haiden A ^a  

^a HARVARD MEDICAL SCHOOL   (United States)

^b BRIGHAM AND WOMEN S HOSPITAL   (United States)

Author keywords

[No Author keywords available]

Indexed keywords

PRESCRIPTION DRUG;

AGED; ARTICLE; COHORT ANALYSIS; CONTROLLED STUDY; ELDERLY CARE; FEMALE; HEALTH CARE COST; HOSPITAL CARE; HUMAN; MALE; MEDICAL FEE; MEDICARE; NURSING HOME; OUTPATIENT CARE; PRIORITY JOURNAL; SELF REPORT; UNITED STATES;

EID: 79960704052     PISSN: 00987484     EISSN: 15383598     Source Type: Journal    
DOI: 10.1001/jama.2011.1026     Document Type: Article

References (44)

1. Donohue JM, Zhang Y, Lave JR, et al. The Medicare drug benefit (Part D) and treatment of heart failure in older adults. Am Heart J. 2010;160(1):159-165.
2. Duggan M, Morton FS. The effect of Medicare Part D on pharmaceutical prices and utilization. Am Econ Rev. 2010;100(1):590-607.
3. Ketcham JD, Simon KI. Medicare Part D's effects on elderly patients' drug costs and utilization. Am J Manag Care. 2008;14(11)(suppl):SP14-SP22.
4. Lichtenberg FR, Sun SX. The impact of Medicare Part D on prescription drug use by the elderly. Health Aff (Millwood). 2007;26(6):1735-1744.
5. Madden JM, Graves AJ, Ross-Degnan D, Briesacher BA, Soumerai SB. Cost-related medication nonadherence after implementation of Medicare Part D, 2006-2007. JAMA. 2009;302(16):1755-1756.
6. Safran DG, Strollo MK, Guterman S, Li A, Rogers WH, Neuman P. Prescription coverage, use and spending before and after Part D implementation: a national longitudinal panel study. JGen Intern Med. 2010;25(1):10-17.
7. Schneeweiss S, Patrick AR, Pedan A, et al. The effect of Medicare Part D coverage on drug use and cost sharing among seniors without prior drug benefits. Health Aff (Millwood). 2009;28(2):w305-w316.
8. Yin W, Basu A, Zhang JX, Rabbani A, Meltzer DO, Alexander GC. The effect of the Medicare Part D prescription benefit on drug utilization and expenditures. Ann Intern Med. 2008;148(3):169-177. (Pubitemid 351665504)
9. Zhang Y, Lave JR, Donohue JM, Fischer MA, Chernew ME, Newhouse JP. The impact of Medicare Part D on medication adherence among older adults enrolled in Medicare-Advantage products. Med Care. 2010;48(5):409-417.
10. Zhang Y, Donohue JM, Lave JR, O'Donnell G, Newhouse JP. The effect of Medicare Part D on drug and medical spending. N Engl J Med. 2009;361(1):52-61.
11. Chandra A, Gruber J, McKnight R. Patient cost-sharing and hospitalization offsets in the elderly. Am Econ Rev. 2010;100(1):193-213.
12. Hsu J, Price M, Huang J, et al. Unintended consequences of caps on Medicare drug benefits. N Engl J Med. 2006;354(22):2349-2359. (Pubitemid 43801280)
13. Tamblyn R, Laprise R, Hanley JA, et al. Adverse events associated with prescription drug cost-sharing among poor and elderly persons. JAMA. 2001;285(4):421-429. (Pubitemid 32097260)
14. Afendulis CC, He Y, Zaslavsky AM, Chernew ME. The impact of Medicare Part D on hospitalizationrates [published online ahead of print February 9, 2011]. Health Serv Res. doi:10.1111/j.1475-6773.2011.01244.x.
15. Ingber M, Greenwald LM, Freeman S, Healy D. Medicare Part D program evaluation: analysis of the impact of Medicare Part D on the FFS program. Centers for Medicare & Medicaid Services Web site. https://www.cms.gov/ reports/downloads/PartD-Ingber-2010.pdf. 2010. Accessed April 8, 2011.
16. Health and Retirement Study (HRS). HRS 1992-2008 public use datasets,1992-2006 restricted geographic identifiers, and 1991-2007 restricted linked Medicare claims files (produced and distributed by the University of Michigan with funding from the National Institute on Aging [grant number NIA U01AG009740]. Ann Arbor, MI). University of Michigan Web site. http://hrsonline.isr.umich.edu/index.php?p=data. Accessed July 7, 2011.
17. Sample sizes and response rates (2002 and beyond). Health and Retirement Study Web site. http://hrsonline.isr.umich.edu/sitedocs/sampleresponse.pdf. 2008. Accessed April 8, 2011.
18. 2011 Economic Report of the President: 2011 report spreadsheet tables. http://www.gpoaccess.gov/eop/tables11.html. Accessed April 8, 2011.
19. Centers for Medicare & Medicaid Services Chronic Condition Data Warehouse Web site. Accessed April 8, 2011. http://www.ccwdata.org/.
20. Huskamp HA, West JC, Rae DS, Rubio-Stipec M, Regier DA, Frank RG. Part D and dually eligible patients with mental illness: medication access problems and use of intensive services. Psychiatr Serv. 2009;60(9):1169-1174.
21. Heeringa SG, Connor JH. Technical description of the Health and Retirement Study sample design. Health and Retirement Study Web site. http://hrsonline.isr.umich.edu/docs/userg/HRSSAMP.pdf. 1995. Accessed April 8, 2011.
22. Binder DA. On the variances of asymptotically normal estimators from complex surveys. Int Stat Rev. 1983;51:279-292.
23. Zhang Y, Donohue JM, Lave JR, Gellad WF. The impact of Medicare Part D on medication treatment of hypertension. Health Serv Res. 2011;46(1, pt 1):185-198.
24. Zhang Y, Lee BY, Donohue JM. Ambulatory antibiotic use and prescription drug coverage in older adults. Arch Intern Med. 2010;170(15):1308-1314.
25. Cost estimate for H.R. 4872, Reconciliation Act of 2010 (final health care legislation). Congressional Budget Office Web site. http://www.cbo.gov/ ftpdocs/113xx/doc11379/AmendReconProp.pdf. 2010. Accessed April 8, 2011.
26. Issues in designing a prescription drug benefit for Medicare. Congressional Budget Office Web site. http://www.cbo.gov/ftpdocs/39xx/doc3960/ 10-30-PrescriptionDrug.pdf. 2002. Accessed April 8, 2011.
27. Raebel MA, Delate T, Ellis JL, Bayliss EA. Effects of reaching the drug benefit threshold on Medicare members' healthcare utilization during the first year of Medicare Part D. Med Care. 2008;46(10):1116-1122.
28. Zhang Y, Donohue JM, Newhouse JP, Lave JR. The effects of the coverage gap on drug spending: a closer look at Medicare Part D. Health Aff (Millwood). 2009;28(2):w317-w325.
29. Fung V, Mangione CM, Huang J, et al. Falling into the coverage gap: Part D drug costs and adherence for Medicare Advantage prescription drug plan beneficiaries with diabetes. Health Serv Res. 2010;45(2):355-375.
30. Hsu J, Fung V, Price M, et al. Medicare beneficiaries' knowledge of Part D prescription drug program benefits and responses to drug costs. JAMA. 2008;299(16):1929-1936. (Pubitemid 351574923)
31. Gu Q, Zeng F, Patel BV, Tripoli LC. Part D coverage gap and adherence to diabetes medications. Am J Manag Care. 2010;16(12):911-918.
32. Hales JW, George S. How the doughnut hole affects prescription fulfillment decisions involving cardiovascular medications for Medicare Part D enrollees. Manag Care. 2010;19(12):36-44.
33. Shrank WH, Choudhry NK. Time to fill the doughnuts - health care reform and Medicare Part D. N Engl J Med. 2011;364(7):598-601.
34. Fisher ES, McClellan MB, Bertko J, et al. Fostering accountable health care: moving forward in medicare. Health Aff (Millwood). 2009;28(2):w219-w231.
35. Federman AD, Adams AS, Ross-Degnan D, Soumerai SB, Ayanian JZ. Supplemental insurance and use of effective cardiovascular drugs among elderly medicare beneficiaries with coronary heart disease. JAMA. 2001;286(14):1732- 1739. (Pubitemid 33010259)
36. Fortess EE, Soumerai SB, McLaughlin TJ, Ross-Degnan D. Utilization of essential medications by vulnerable older people after a drug benefit cap: importance of mental disorders, chronic pain, and practice setting. J Am Geriatr Soc. 2001;49(6):793-797. (Pubitemid 32652474)
37. Heisler M, Langa KM, Eby EL, Fendrick AM, Kabeto MU, Piette JD. The health effects of restricting prescription medication use because of cost. Med Care. 2004;42(7):626-634.
38. Stuart BC, Doshi JA, Terza JV. Assessing the impact of drug use on hospital costs. Health Serv Res. 2009;44(1):128-144.
39. Stuart BC, Simoni-Wastila L, Zhao L, Lloyd JT, Doshi JA. Increased persistency in medication use by U.S. Medicare beneficiaries with diabetes is associated with lower hospitalization rates and cost savings. Diabetes Care. 2009;32(4):647-649.
40. Choudhry NK, Avorn J, Antman EM, Schneeweiss S, Shrank WH. Should patients receive secondary prevention medications for free after a myocardial infarction? an economic analysis. Health Aff (Millwood). 2007;26(1):186-194.
41. Choudhry NK, Patrick AR, Antman EM, Avorn J, Shrank WH. Cost-effectiveness of providing full drug coverage to increase medication adherence in post-myocardial infarction Medicare beneficiaries. Circulation. 2008;117(10):1261-1268. (Pubitemid 351365674)
42. Ray KK, Cannon CP, McCabe CH, et al; PROVE IT-TIMI 22 Investigators. Early and late benefits of high-dose atorvastatin in patients with acute coronary syndromes: results from the PROVE ITTIMI 22 trial. J Am Coll Cardiol. 2005;46(8):1405-1410. (Pubitemid 41446173)
43. Yusuf S, Zhao F, Mehta SR, Chrolavicius S, Tognoni G, Fox KK; Clopidogrel in Unstable Angina to Prevent Recurrent Events Trial Investigators. Effects of clopidogrel in addition to aspirin in patients with acute coronary syndromes without ST-segment elevation. N Engl J Med. 2001;345(7):494-502. (Pubitemid 32758501)
44. Chernew ME, Rosen AB, Fendrick AM. Value-based insurance design. Health Aff (Millwood). 2007;26(2):w195-w203.