The Impact of Medicare Part D on Medication Adherence Among Older Adults Enrolled in Medicare-Advantage Products

Abstract

Part D increased adherence to medications that reduce the risk of cardiovascular events for patients with hypertension, diabetes, and hyperlipidemia. This should improve the health of the elderly people in the long run.

Drug Benefit Changes Under Medicare Advantage Part D: Heterogeneous Effects on Pharmaceutical Use and Expenditures

“…Our study extends that of Zhang et al [10][11][12] in three ways. Their intervention groups were defined by the pre-Part D cap on drug benefits, and they did not seek to distinguish between enrollees with and without gap coverage after Part D, as we do.…”

“…For example, between 2005 and 2006, those with gap coverage increased their drug utilization by about 54 more days supply, and their drug expenditures by about $140 more, than those without gap coverage. These differences were even larger among the subset of patients at high risk of gap entry (74 days and $240 respectively), a population of strong policy interest that was not examined in the earlier studies [10][11][12] . Eliminating the Part D coverage gap for branded drugs would have increased these differences even more, so these estimates represent a lower bound on the likely effects of eliminating the gap under the ACA.…”

“…Using pharmacy, enrollment, and benefits data on MAPD enrollees, Zhang and colleagues compared changes in drug utilization and spending before and after Part D among enrollees whose coverage did not change, enrollees who newly acquired drug coverage, enrollees whose drug benefits improved slightly, and enrollees whose benefits improved substantially [10][11][12] . They concluded that Part D increased drug utilization and adherence and decreased out-of-pocket spending, but changes were smaller for beneficiaries with more generous prior drug coverage.…”

Vital Signs: Disparities in Antihypertensive Medication Nonadherence Among Medicare Part D Beneficiaries — United States, 2014

“…In 2015, approximately 39 million beneficiaries were enrolled in Medicare Part D, 61% of whom were enrolled in stand-alone prescription drug plans (PDPs) that supplement Original Medicare † coverage and 39% of whom were enrolled in Medicare Advantage § prescription drug (MA-PD) plans (7). The implementation of the Medicare Part D program has been associated with up to a 13.5% improvement in antihypertensive adherence among beneficiaries (8). However, antihypertensive nonadherence continues to pose a threat to this population's health, especially among certain demographic groups (9).…”

Impact of Medicare Part D for Medicare‐age adults with arthritis: Prescription use, prescription expenditures, and medical spending from 2005 to 2008

“…Total and OOP drug expenditures have not changed significantly for dual-eligibles (7), but reductions in OOP drug expenditures and increases in utilization of statins and proton-pump inhibitors have been observed among those without previous drug coverage (6,10). In patients with diabetes mellitus with no or minimal previous drug benefit, the implementation of Part D was associated with improved adherence to medications, increased prescription drug expenditures, and decreased spending in other medical services (11,12).…”