Abstract
Objective:
To evaluate the impact of Medicare Part D on medication utilization, drug expenditures, and medical expenditures in patients with arthritis.
Methods:
This was a retrospective study using a national sample of 2,484 Medicare-eligible beneficiaries with arthritis from the pooled Medical Expenditure Panel Survey 2005-2008 data. Quantile regression was used to estimate the following outcomes: 1) number of prescription fills, 2) total drug expenditures, 3) out-of-pocket (OOP) drug expenditures, 4) Medicare-paid drug expenditures, 5) total medical expenditures (including all payments for inpatient/outpatient care, prescription drugs, and other medical services), 6) OOP medical expenditures, and 7) Medicare-paid medical expenditures. For each outcome variable, the 50th, 75th, and 90th percentiles were estimated, adjusting for demographics and comorbidity. All expenditures were inflation-adjusted to 2008 dollars.
Results:
From 2005 to 2008, the adjusted median annual number of prescription fills (percentage change in parenthesis) increased by 4.2 (14.6%), from 28.4 to 32.6. The adjusted median OOP drug expenditures and OOP medical expenditures decreased by $151 (25.2%) and $197 (17.3%), respectively. The adjusted median Medicare-paid drug and medical expenditures increased by $366 and $896 (39.5%), respectively. The adjusted total prescription expenditures increased by $844 (25.3%) at the 75th percentile and by $1,194 (22.0%) at the 90th percentile. The adjusted total medical expenditures did not change significantly.
Conclusion:
Medicare Part D resulted in increased medication utilization and significant reductions in OOP drug and OOP medical expenditures among beneficiaries with arthritis three years after its implementation. Part D was not associated with significant differences in total medical spending. © 2012 by the American College of Rheumatology
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