Effect of Medicare Part D and insurance type on Medicare beneficiary access to prescription medication and use of prescription cost-saving measures

• Published in: Journal of the American Pharmacists Association Vol. 51; no. 1; pp. 72 - 81
• Main Authors: Urmie, Julie M., PhD, Farris, Karen B., PhD, Doucette, William R., PhD, Goedken, Amber M., PharmD
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 2011
• Subjects: Aged; Aged, 80 and over; Cost Savings; Cross-Sectional Studies; Drug Costs; drug costs and expenditures; elderly; Fees, Pharmaceutical; Female; Health Services Accessibility - statistics & numerical data; Humans; Insurance, Pharmaceutical Services; Internal Medicine; Male; Medicare Part D; medication access; Prescription Drugs - economics; Prescription Drugs - therapeutic use; United States; United States; medication access; elderly; Medicare Part D; drug costs and expenditures
• ISSN: 1544-3191; 1544-3450
• DOI: 10.1331/JAPhA.2011.09239

Objectives To examine how prescription drug access and use of prescription cost-saving measures changed after Medicare Part D was implemented and to determine their predictors in Medicare beneficiaries with different insurance types. Design Repeated cross-sectional study. Setting United States in 2005 and 2007. Patients Medicare beneficiaries aged 65 years or older (n = 1,220 in 2005 and n = 1,024 in 2007). Intervention Web-based surveys using nonprobability samples. Main outcome measures Access to prescription drugs and use of seven cost-saving measures. Results Significantly fewer participants stopped taking a prescription because of cost, applied to an assistance program, received free prescription samples, and had limited prescription access in 2007 compared with 2005. Use of cost-saving measures by Medicare Part D patients was more comparable with that by uninsured participants than patients with employer-based drug coverage. One-third of all participants and almost one-half of Medicare Part D participants had requested a less expensive prescription. Among those participants, 70% received a less expensive prescription and most thought it worked about the same as the more expensive prescription. Conclusion Prescription drug access and use of cost-saving measures improved somewhat following the implementation of Medicare Part D, but some access problems continued to exist for Part D participants. Requests for less expensive prescriptions were common and frequently resulted in satisfactory switches.