Mail-order pharmacy use and medication adherence among Medicare Part D beneficiaries with diabetes

Zhang, Lihua; Zakharyan, Armen; Stockl, Karen M.; Harada, Ann S. M.; Curtis, Bradford; Solow, Brian K.

doi:10.3111/13696998.2011.598200

Cited by 44 publications

(44 citation statements)

References 22 publications

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“…35–39 This study provides additional evidence that exposure to mail order pharmacy across racial and ethnic subgroups, rather than differential response to this practice, contributes to disparities in adherence. 36 However, it is important to note that all patients using mail order pharmacy in this setting also had access to telephone based counseling from pharmacists and approximately one-third also received a financial incentive (i.e., lower copays) for participating in the program.…”

Section: Discussionmentioning

confidence: 85%

Health System Factors and Antihypertensive Adherence in a Racially and Ethnically Diverse Cohort of New Users

Adams

Uratsu²,

Dyer³

et al. 2013

JAMA Intern Med

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Section: Discussionmentioning

confidence: 85%

Health System Factors and Antihypertensive Adherence in a Racially and Ethnically Diverse Cohort of New Users

Adams

Uratsu²,

Dyer³

et al. 2013

JAMA Intern Med

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“…Barriers for optimal adherence to treatments for T2D could be due to regimen complexity. Studies examining the association between anti-diabetes medication regimen complexity and anti-diabetes medication adherence have shown that regimens with less frequent dosing are associated with increased adherence [34, 35]. However, adherence to treatments after a certain period of time is similar for orals and injectables, so lack of adherence may not be solely based on regimen complexity.…”

Section: Discussionmentioning

confidence: 99%

Glucagon-Like Peptide-1 Receptor Agonist (GLP-1RA) Therapy Adherence for Patients with Type 2 Diabetes in a Medicare Population

2017

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IntroductionAnti-diabetes medication regimen adherence is a clinical challenge in elderly patients with type 2 diabetes (T2D) and other comorbidities associated with aging. Glucagon-like peptide-1 receptor agonists (GLP-1RA) therapies such as exenatide once weekly (QW), exenatide twice daily (BID), and liraglutide once daily (QD) are an increasingly used class of drugs with proven efficacy and tolerability. Real-world evidence on adherence to GLP-1RAs in elderly or disabled patients is limited. To further the understanding of this drug class, the current study examined medication adherence in Medicare patients aged ≥65 years with T2D initiating a GLP-1RA.MethodsThis retrospective cohort study used medical and pharmacy claims between 2010 and 2013 for Medicare members in a United States health plan diagnosed with T2D who were new initiators of either exenatide QW (n = 537), exenatide BID (n = 923), or liraglutide QD (n = 3,673). Included patients were between the ages of 65 and 89 and were continuously enrolled for 6 months pre- and post-index. Medication adherence was examined during the post-index period using proportion of days covered (PDC) ≥80% and ≥90%.ResultsA significantly higher percentage of patients receiving exenatide QW had a PDC ≥80% (43.2%) versus exenatide BID (39.0%, P < 0.01) and liraglutide QD (35.0%, P < 0.001). The patients receiving exenatide QW were significantly more likely to reach a PDC of ≥90% (37.2%, P < 0.001) than those initiating exenatide BID (20.6%) or liraglutide QD (23.3%).ConclusionsWhile results from this retrospective study suggest room for improvement in adherence to GLP-1RAs, medication adherence rates for patients initiating therapy with exenatide QW were higher than patients initiating therapy with exenatide BID or liraglutide QD. Further research is needed to validate these findings in other T2D patient populations. Funding: AstraZeneca Pharmaceuticals.

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“…Stuart et al 25 —using 2006 claims data from a random 5% file of Medicare beneficiaries (n = 45,613 PDP enrollees) and from retiree health plans (n = 211,919)—found no statistical difference between PDP and retiree health plan enrollees in medication possession ratios or duration of most therapies for diabetes. Using 2008–2009 claims data (n = 22,546), Zhang et al 26 reported that only 42% of all respondents attained adherence with oral antidiabetic medications but that adherence rates were higher among respondents using mail-order pharmacies than those using walk-in pharmacies (49.7% vs 42.8%). Additionally, 3 studies examined antidepressant/antipsychotic agents.…”

Section: Resultsmentioning

confidence: 99%

“…Although the net effects of Part D are overall decreases in CRN and nonpersistence, 20,21 additional interventions may be necessary to target beneficiaries with certain health conditions, including ESRD, 24 diabetes, 26 and psychosis. 29 Before the coverage gap is phased out (by 2020), providers should closely monitor CRN and drug discontinuation during the gap to avoid potential adverse clinical consequences, 22 especially in patients on osteoporosis treatments.…”

Section: Resultsmentioning

confidence: 99%

Medicare Part D Research and Policy Highlights, 2012: Impact and Insights

Lau

Stubbings

2012

Clinical Therapeutics

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Background In the 6 years since the implementation of Medicare Part D in the United States, the program has been reported to improve quality, offer better beneficiary protections, and lower drug costs. Objective The purpose of this article was to highlight the latest key peer-reviewed research findings on Medicare Part D and major public policy initiatives for Part D for 2012. Methods PubMed was searched for studies on Medicare Part D published in 2011 in biomedical/scientific, peer-reviewed, English-language journals. For the policy update, sources included the Federal Register, the Medicare Prescription Drug Benefit Manual, the 2012 Final Call Letter, and guidance from the Centers for Medicare and Medicaid Services. Results Medicare Part D has been associated with increased medication utilization, reduced out-of-pocket expenditures, and an overall decrease in cost-related non-adherence and nonpersistence. Its impact on reduction in non-drug utilization of health services has been more apparent after the transition year in 2006 and among subsets of Medicare beneficiaries. Recent policy changes promise to make Part D more user-friendly, simplify choice, and offer greater protection to beneficiaries. The coverage gap will phase out by 2020. Both the quality rating system for prescription drug plans and medication therapy management programs were enhanced. Conclusions Although Part D was designed to improve drug benefits, improvements may be needed in plan selection and simplification, quality assessment (especially with regard to long-term impact and health outcomes), evidence-based improvements in medication therapy management, and disparities among priority subpopulations. Medicare Parts A, B, and D could be coordinated to offset costs by increasing medication expenses and decreasing expenses for nonprescription medical services, thereby improving the overall cost-effectiveness of the Medicare program.

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Mail-order pharmacy use and medication adherence among Medicare Part D beneficiaries with diabetes

Cited by 44 publications

References 22 publications

Health System Factors and Antihypertensive Adherence in a Racially and Ethnically Diverse Cohort of New Users

Health System Factors and Antihypertensive Adherence in a Racially and Ethnically Diverse Cohort of New Users

Glucagon-Like Peptide-1 Receptor Agonist (GLP-1RA) Therapy Adherence for Patients with Type 2 Diabetes in a Medicare Population

Medicare Part D Research and Policy Highlights, 2012: Impact and Insights

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