| Utilization and Costs of Cardiovascular Disease Medications in Dialysis Patients in Medicare Part D. | |
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MedLine Citation:
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PMID: 22206743 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
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BACKGROUND: Cardiovascular disease (CVD) is a major source of mortality and morbidity in dialysis patients. Population-level descriptions of CVD medication use are lacking in this population. STUDY DESIGN: Retrospective cohort study. SETTING & PARTICIPANTS: Adult dialysis patients in the United States, alive on December 31, 2006, with Medicare Parts A and B and enrollment in Medicare Part D continuously in 2007. PREDICTOR: CVDs and demographic characteristics. OUTCOME: ≥1 prescription fill during follow-up (2007). MEASUREMENTS: Average out-of-pocket costs per user per month and average total drug costs per member per month were calculated. RESULTS: Of 225,635 dialysis patients who met inclusion criteria during the entry period, 70% (n = 158,702) had continuous Part D coverage during follow-up. Of these, 76% received the low-income subsidy. β-Blockers were the most commonly used CVD medication (64%), followed by renin-angiotensin system inhibitors (52%), calcium channel blockers (51%), lipid-lowering agents (44%), and α-agonists (23%). Use varied by demographics, geographic region, and low-income subsidy status. For CVD medications, mean out-of-pocket costs per user per month were $3.44 and $49.59 and mean total costs per member per month were $124.02 and $110.32 for patients with and without the low-income subsidy, respectively. LIMITATIONS: Information was available for only filled prescriptions under the Part D benefit; information for clinical contraindications was lacking, information for over-the-counter medications was unavailable, and medication adherence and persistence were not examined. CONCLUSIONS: Most Medicare dialysis patients in 2007 were enrolled in Part D, and most enrollees received the low-income subsidy. β-Blockers were the most used CVD medication. Total costs of CVD medications were modestly higher for low-income subsidy patients, but out-of-pocket costs were much higher for patients not receiving the subsidy. Further study is warranted to delineate sources of variation in the use and costs of CVD medications across subgroups. |
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Authors:
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Diane L Frankenfield; Eric D Weinhandl; Christopher A Powers; Benjamin L Howell; Charles A Herzog; Wendy L St Peter |
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Publication Detail:
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Type: JOURNAL ARTICLE Date: 2011-12-27 |
Journal Detail:
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Title: American journal of kidney diseases : the official journal of the National Kidney Foundation Volume: - ISSN: 1523-6838 ISO Abbreviation: - Publication Date: 2011 Dec |
Date Detail:
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Created Date: 2011-12-30 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 8110075 Medline TA: Am J Kidney Dis Country: - |
Other Details:
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Languages: ENG Pagination: - Citation Subset: - |
Copyright Information:
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Published by Elsevier Inc. |
Affiliation:
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Centers for Medicare & Medicaid Services, Center for Medicare and Medicaid Innovation, Baltimore, MD. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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