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

Frank Xiaoqing Liu, G. Caleb Alexander, Stephanie Y. Crawford, A. Simon Pickard, Donald Hedeker, Surrey M. Walton

Research output: Contribution to journalArticlepeer-review

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.

Original languageEnglish (US)
Pages (from-to)1104-1123
Number of pages20
JournalHealth services research
Volume46
Issue number4
DOIs
StatePublished - Aug 1 2011
Externally publishedYes

Keywords

  • Medicare Part D
  • health care utilization
  • health outcomes
  • insurance
  • prescriptions

ASJC Scopus subject areas

  • Health Policy

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