+ Site Statistics
+ Search Articles
+ PDF Full Text Service
How our service works
Request PDF Full Text
+ Follow Us
Follow on Facebook
Follow on Twitter
Follow on LinkedIn
+ Subscribe to Site Feeds
Most Shared
PDF Full Text
+ Translate
+ Recently Requested

How the Medicare Part D drug benefit changed the distribution of out-of-pocket pharmacy spending among older beneficiaries

How the Medicare Part D drug benefit changed the distribution of out-of-pocket pharmacy spending among older beneficiaries

Journals of Gerontology. Series B, Psychological Sciences and Social Sciences 65(4): 502-507

To examine the impact of the Medicare drug benefit (Part D) on the distribution of out-of-pocket pharmacy spending among older adults. We used a pre-post-with-comparison-group design to compare four groups of beneficiaries continuously enrolled in a Medicare Advantage plan between 2004 and 2007: three intervention groups with no or limited (quarterly caps of $150 or $350) prior coverage that obtained Part D benefits in 2006 and a comparison group with stable drug coverage from 2004 to 2007. The comparison group's out-of-pocket drug spending was stable throughout 2004-2007, whereas Part D reduced out-of-pocket spending 13.4% among those without prior coverage (95% confidence interval [CI] -17.1% to -9.1%) and 15.9% among those with $150 quarterly caps (95% CI -19.1% to -12.8%) relative to the comparison group. Individuals in the top decile of drug spending paid a greater share of their costs out-of-pocket than others in the top 5 deciles. Although Part D reduced out-of-pocket expenditures for older adults, those with the highest drug spending still pay a substantial share of their drug costs out-of-pocket. Thus, the Part D benefit does not achieve a primary purpose of insurance-to offer the greatest financial protection to those at the highest risk.

Please choose payment method:

(PDF emailed within 0-6 h: $19.90)

Accession: 053597322

Download citation: RISBibTeXText

PMID: 20008482

DOI: 10.1093/geronb/gbp111

Related references

Closing the Medicare Doughnut Hole: Changes in Prescription Drug Utilization and Out-of-Pocket Spending Among Medicare Beneficiaries With Part D Coverage After the Affordable Care Act. Medical Care 55(1): 43-49, 2016

Out-of-pocket spending on health care by Medicare beneficiaries age 65 and older: 1999 projections. Issue Brief ): 1-14, 2000

Generic Drug Price Hikes And Out-Of-Pocket Spending For Medicare Beneficiaries. Health Affairs 37(10): 1578-1586, 2018

National trends in out-of-pocket prescription drug spending among elderly medicare beneficiaries. Expert Review of Pharmacoeconomics & Outcomes Research 5(3): 297-315, 2005

Riding the rollercoaster: the ups and downs in out-of-pocket spending under the standard Medicare drug benefit. Health Affairs 24(4): 1022-1031, 2005

Characteristics of Medicare Part D beneficiaries who reach the drug benefit threshold in both of the first two years of the Part D benefit. Medical Care 48(3): 267-272, 2010

Effect of cost sharing on prescription drug use by Medicare beneficiaries prior to the Medicare Drug Benefit and potential adverse selection in the benefit. Journal of the American Pharmacists Association 49(1): 18-25, 2009

Out-of-Pocket Spending and Financial Burden Among Medicare Beneficiaries With Cancer. JAMA Oncology 3(6): 757-765, 2016

Effects of Medicare Part D on drug affordability and use: Are seniors with prior high out-of-pocket drug spending affected more?. Research in Social & Administrative Pharmacy 6(2): 90-99, 2010

Falling into the doughnut hole: drug spending among beneficiaries with end-stage renal disease under Medicare Part D plans. Journal of the American Society of Nephrology 17(9): 2546-2553, 2006

Low-income Medicare beneficiaries and their experiences with the part D prescription drug benefit. Inquiry 47(2): 162-172, 2010

Association of Prescription Drug Price Rebates in Medicare Part D With Patient Out-of-Pocket and Federal Spending. JAMA Internal Medicine 177(8): 1185-1188, 2017

Alzheimer Disease and Related Disorders and Out-of-Pocket Health Care Spending and Burden Among Elderly Medicare Beneficiaries. Medical Care: -, 2018

Medication strategies used by Medicare beneficiaries who reach the Part D standard drug-benefit threshold. American Journal of Health-System Pharmacy 65(11): 1062-1070, 2008

Attitudes of Medicare beneficiaries toward pharmacist-provided medication therapy management activities as part of the Medicare Part D benefit. Journal of the American Pharmacists Association 47(6): 758-762, 2007