The impact of Medicare Part D on out-of-pocket costs for prescription drugs, medication utilization, health resource utilization, and preference-based health utility

Health Serv Res. 2011 Aug;46(4):1104-23. doi: 10.1111/j.1475-6773.2011.01273.x. Epub 2011 May 24.

Abstract

Objectives: To quantify the impact of Medicare Part D eligibility on medication utilization, emergency department use, hospitalization, and preference-based health utility among civilian noninstitutionalized Medicare beneficiaries.

Study design: Difference-in-differences analyses were used to estimate the effects of Part D eligibility on health outcomes by comparing a 12-month period before and after Part D implementation using the Medical Expenditure Panel Survey. Models adjusted for sociodemographic characteristics and health status and compared Medicare beneficiaries aged 65 and older with near elderly aged 55-63 years old.

Principal findings: Five hundred and fifty-six elderly and 549 near elderly were included. After adjustment, Part D was associated with a U.S.$179.86 (p=.034) reduction in out-of-pocket costs and an increase of 2.05 prescriptions (p=.081) per patient year. The associations between Part D and emergency department use, hospitalizations, and preference-based health utility did not suggest cost offsets and were not statistically significant.

Conclusions: Although there was a substantial reduction in out-of-pocket costs and a moderate increase in medication utilization among Medicare beneficiaries during the first year after Part D, there was no evidence of improvement in emergency department use, hospitalizations, or preference-based health utility for those eligible for Part D during its first year of implementation.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Age Factors
  • Aged
  • Body Mass Index
  • Drug Utilization
  • Financing, Personal / economics*
  • Health Behavior
  • Health Services / statistics & numerical data*
  • Health Services Research / statistics & numerical data
  • Humans
  • Medicare Part D / statistics & numerical data*
  • Middle Aged
  • Models, Economic
  • Prescription Drugs / economics*
  • Socioeconomic Factors
  • United States

Substances

  • Prescription Drugs