OBJECTIVES: With US healthcare reform proposing to extend Medicare coverage to individuals between the ages of 55-64, the pressure for coverage will dramatically increase.  We examined demand five drug markets—cholesterol, diabetes, depression, hypertension and pain—for this age group compared to others.  We also compared the cost burden under Medicare Part D compared payers to highlight the demand for more affordable drugs from individuals that are not yet eligible for Medicare coverage. METHODS: For each drug market, total prescriptions (TRx), new patient prescriptions (NPRx), and average prescription size were obtained for each of the age groups analyzed (≤18, 19-35, 36-54, 55-64, ≥65).  For each drug market, average out of pocket cost (OPC) was also compared between Medicare beneficiaries and other patients. Data were collected for eight quarters, spanning November 2007 to November 2009 using SDI’s VONA and VOPA databases. Statistical analyses were performed using one-way ANOVA; significant results had p<0.05. RESULTS: Although individuals ages 55-64 did not dominate the NPRx—ranging from 15% to 26%—this group was the second-largest contributor to all prescriptions (TRx) for all the drug markets, ranging from 20% to 30%.  The average size of prescriptions for this age range was statistically equivalent to the average size for the ≥65 population, indicating that prescriptions were refilled equally frequently in both populations.  Medicare beneficiaries paid significantly less, on average, for drugs in the five classes compared to others by a margin of 20% to 93%. CONCLUSIONS: Individuals approaching Medicare eligibility are a demographic with significant demand for coverage.  They show consistently high drug demand; prescription sizes are equal to patients over 65 and costs significantly higher Medicare patients, resulting in a great expenditure for covering this population.  From the consumer perspective, it is important to recognize that the combination of higher OPC and high prescription demand creates a significant cost burden.