Document Detail

Impact of Part D Low-income Subsidies on Medication Patterns for Medicare Beneficiaries With Diabetes.
MedLine Citation:
PMID:  23047779     Owner:  NLM     Status:  In-Data-Review    
BACKGROUND: : It is not known whether low-income subsidies (LIS) under Medicare Part D help beneficiaries overcome impediments to medication use associated with poor socioeconomic status and high disease burden.
OBJECTIVES: : To compare Medicare beneficiaries with LIS and Medicaid (duals), LIS without dual eligibility, and non-LIS recipients on use of medications recommended in diabetes treatment.
RESEARCH DESIGN: : Fixed-effect comparisons among beneficiaries in the same Part D plans in 2006-2007.
SUBJECTS: : Nationally representative sample of enrollees in Part D prescription drug plans. A total of 109,292 beneficiaries were in 204 prescription drug plans; 47.5% non-LIS, 44.4% duals, and 8.1% nondual LIS recipients.
MEASURES: : Medications included antidiabetic agents, renin-angiotensin-aldosterone system inhibitors, and antihyperlipidemics. Drug use was measured by exposure, duration of therapy, and medication possession ratio.
RESULTS: : The LIS dual cohort had significantly higher comorbidity compared with non-LIS comparisons, LIS nonduals were significantly more likely to take medications in all 3 drug classes compared with non-LIS recipients, but differences were small (between 2% and 4%; P<0.05). Non-LIS recipients and duals had equivalent exposure to any antidiabetic drug and antihyperlipidemics, but duals were 3% less likely to receive renin-angiotensin-aldosterone system inhibitors compared with non-LIS recipients (P<0.05). Small differences in adjusted values for duration of therapy and medication possession ratio among the 3 cohorts were also observed, none of which were clinically meaningful.
CONCLUSIONS: : Similarities in medication utilization among Part D enrollees with and without LIS coverage supports the program objective of providing enhanced access to needed medications for diverse groups of Medicare beneficiaries.
Bruce Stuart; Xianghua Yin; Amy Davidoff; Linda Simoni-Wastila; Ilene Zuckerman; J Samantha Shoemaker; Jalpa Doshi
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Medical care     Volume:  50     ISSN:  1537-1948     ISO Abbreviation:  Med Care     Publication Date:  2012 Nov 
Date Detail:
Created Date:  2012-10-10     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0230027     Medline TA:  Med Care     Country:  United States    
Other Details:
Languages:  eng     Pagination:  913-9     Citation Subset:  IM    
*Pharmaceutical Health Services Research Department, The Peter Lamy Center on Drug Therapy and Aging, University of Maryland School of Pharmacy †Epidemiology and Public Health Department, The Peter Lamy Center on Drug Therapy and Aging, University of Maryland, Baltimore, MD ‡Division of General Internal Medicine, University of Pennsylvania School of Medicine, Philadelphia, PA.
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