Patterns of prescription drug expenditures and medication adherence among medicare part D beneficiaries with and without the low-income supplementReport as inadecuate




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BMC Health Services Research

, 14:665

Utilization, expenditure, economics and financing systems

Abstract

BackgroundThe association between the Medicare Part D low-income subsidy LIS, gap coverage, and outcomes such as medical expenditures, prescription fills, and medication adherence is not well understood. The purpose of this study was to examine the relationship between the LIS and these measures for patients within a large, national Part D plan in the United States.

MethodsIn this cross-sectional, retrospective analysis, we compared total and plan expenditures, out-of-pocket costs, and medication fills and adherence for three categories of Medicare beneficiaries: non-LIS beneficiaries without gap coverage non-LIS-non-GC, non-LIS beneficiaries with gap coverage non-LIS-GC, and LIS beneficiaries LIS.

ResultsLIS beneficiaries, relative to non-LIS-non-GC and non-LIS-GC beneficiaries, had higher total expenditures $1,887 vs. $1,360 vs. $1,341; lower out-of-pocket costs $148 vs. $546 vs. $570; more expenditures exceeding the gap threshold 27.6% vs. 18.4% vs. 16.9%; and slightly higher adherence to blood pressure 65.6% vs. 64.2% vs. 62.4%; diabetes 62.5% vs. 57.7 vs. 57.4%; and lipid-lowering 59.6% vs. 57.0 vs. 55.6% medications.

ConclusionLIS beneficiaries had higher total expenditures, lower out-of-pocket costs, and modestly better adherence to diabetes medications than non-LIS-non-GC and non-LIS-GC beneficiaries.

KeywordsMedicare Part D Low-income subsidy Gap coverage Health care expenditures Adherence to medications Electronic supplementary materialThe online version of this article doi:10.1186-s12913-014-0665-3 contains supplementary material, which is available to authorized users.

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Author: Stella M Yala - Obidiugwu Kenrik Duru - Susan L Ettner - Norman Turk - Carol M Mangione - Arleen F Brown

Source: https://link.springer.com/







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