Effects of Transitioning to Medicare Part D on Access to Drugs for Medical Conditions among Dual Enrollees with Cancer

Dec 1, 2017, 00:00
10.1016/j.jval.2017.05.023
https://www.valueinhealthjournal.com/article/S1098-3015(17)30276-0/fulltext
Title : Effects of Transitioning to Medicare Part D on Access to Drugs for Medical Conditions among Dual Enrollees with Cancer
Citation : https://www.valueinhealthjournal.com/action/showCitFormats?pii=S1098-3015(17)30276-0&doi=10.1016/j.jval.2017.05.023
First page : 1345
Section Title : HEALTH POLICY ANALYSIS
Open access? : No
Section Order : 13

Objectives

To evaluate the impact of transitioning from Medicaid to Medicare Part D drug coverage on the use of noncancer treatments among dual enrollees with cancer.

Methods

We leveraged a representative 5% national sample of all fee-for-service dual enrollees in the United States (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 and black).

Results

The removal of drug caps was associated with increased use of lipid-lowering medications (days’ supply 3.63; 95% confidence interval [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; and days’ supply 4.01; 95% CI 2.92–5.09) and antidepressants (days’ supply 2.20; 95% CI 0.61–3.78) and increasing trends in antihypertensive use (any use 0.01 percentage points; 95% CI 0.004–0.01; and days’ supply 1.83; 95% CI 1.25–2.41). The white-black gap in the use of lipid-lowering medications was immediately reduced (−0.09 percentage points; 95% CI −0.15 to −0.04). We also observed a reversal in trends toward widening white-black differences in antihypertensive use (level −0.08 percentage points; 95% CI −0.12 to −0.05; and trend −0.01 percentage points; 95% CI −0.02 to −0.01) and antidepressant use (−0.004 percentage points; 95% CI −0.01 to −0.0004).

Conclusions

Our findings suggest that the removal of drug caps under Part D had a modest impact on the treatment of hypercholesterolemia overall and may have reduced white-black gaps in the use of lipid-lowering and antidepressant therapies.

Categories :
Tags :
  • comorbidity
  • disparities
  • dual eligibles
  • Medicaid
  • Medicare
  • Part D
Regions :
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