The impact of the medicare part D prescription benefit on generic drug use

James X. Zhang, Wesley Yin, Shawn X. Sun, George Caleb Alexander

Research output: Contribution to journalArticle

Abstract

BACKGROUND: Little information exists regarding the impact of Medicare Part D on generic drug use. OBJECTIVE: To examine changes in the use of generic prescriptions attributable to Part D among a sample of Medicare beneficiaries. DESIGN, PARTICIPANTS, AND MEASUREMENTS: Difference-in-difference analysis of pharmacy claims of Part D enrollees and non-enrollees aged 67-79 years from 2005 to 2006. The final sample represented approximately 2.4 million unique subjects. Analyses were conducted separately for major therapeutic classes, limited to subjects filling at least one prescription within the class during 2005 and 2006, and adjusted for subject characteristics, prescription characteristics, socio-demographic characteristics measured through zipcode-linked Census data, baseline differences between Part D and non-Part D enrollees, and secular trends in generic use. RESULTS: Generic drugs accounted for 58% of total prescriptions. Among the entire group of beneficiaries, there was a trend of increased generic drug use in 13 out of 15 drug classes examined. However, after adjusting for potential confounders, the growth rate of generic drug use was lower among Part D enrollees than among non-enrollees; enrollees were slightly less likely to fill prescriptions for generic drugs vs. brand-name drugs in 2006 compared to 2005 (odds ratio 0.95, 95% confidence interval 0.94-0.95). CONCLUSIONS: Despite secular trends of increased utilization of generic drugs among both Part D enrollees and non-enrollees, the net impact of Part D among these beneficiaries was a modest decrease in the use of generic drugs. This finding, which is consistent with economic theory but contrary to several recent reports, highlights the complexity of assessing the impact of Part D on overall consumer welfare.

Original languageEnglish (US)
Pages (from-to)1673-1678
Number of pages6
JournalJournal of General Internal Medicine
Volume23
Issue number10
DOIs
StatePublished - Oct 2008
Externally publishedYes

Fingerprint

Medicare Part D
Generic Drugs
Prescriptions
Insurance Claim Review
Prescription Drugs
Censuses
Medicare
Pharmaceutical Preparations
Names
Odds Ratio
Economics
Demography
Confidence Intervals

Keywords

  • Generic drugs
  • Medicare Part D
  • Pharmacoepidemiology
  • Prescription coverage

ASJC Scopus subject areas

  • Internal Medicine

Cite this

The impact of the medicare part D prescription benefit on generic drug use. / Zhang, James X.; Yin, Wesley; Sun, Shawn X.; Alexander, George Caleb.

In: Journal of General Internal Medicine, Vol. 23, No. 10, 10.2008, p. 1673-1678.

Research output: Contribution to journalArticle

Zhang, James X. ; Yin, Wesley ; Sun, Shawn X. ; Alexander, George Caleb. / The impact of the medicare part D prescription benefit on generic drug use. In: Journal of General Internal Medicine. 2008 ; Vol. 23, No. 10. pp. 1673-1678.
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abstract = "BACKGROUND: Little information exists regarding the impact of Medicare Part D on generic drug use. OBJECTIVE: To examine changes in the use of generic prescriptions attributable to Part D among a sample of Medicare beneficiaries. DESIGN, PARTICIPANTS, AND MEASUREMENTS: Difference-in-difference analysis of pharmacy claims of Part D enrollees and non-enrollees aged 67-79 years from 2005 to 2006. The final sample represented approximately 2.4 million unique subjects. Analyses were conducted separately for major therapeutic classes, limited to subjects filling at least one prescription within the class during 2005 and 2006, and adjusted for subject characteristics, prescription characteristics, socio-demographic characteristics measured through zipcode-linked Census data, baseline differences between Part D and non-Part D enrollees, and secular trends in generic use. RESULTS: Generic drugs accounted for 58{\%} of total prescriptions. Among the entire group of beneficiaries, there was a trend of increased generic drug use in 13 out of 15 drug classes examined. However, after adjusting for potential confounders, the growth rate of generic drug use was lower among Part D enrollees than among non-enrollees; enrollees were slightly less likely to fill prescriptions for generic drugs vs. brand-name drugs in 2006 compared to 2005 (odds ratio 0.95, 95{\%} confidence interval 0.94-0.95). CONCLUSIONS: Despite secular trends of increased utilization of generic drugs among both Part D enrollees and non-enrollees, the net impact of Part D among these beneficiaries was a modest decrease in the use of generic drugs. This finding, which is consistent with economic theory but contrary to several recent reports, highlights the complexity of assessing the impact of Part D on overall consumer welfare.",
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N2 - BACKGROUND: Little information exists regarding the impact of Medicare Part D on generic drug use. OBJECTIVE: To examine changes in the use of generic prescriptions attributable to Part D among a sample of Medicare beneficiaries. DESIGN, PARTICIPANTS, AND MEASUREMENTS: Difference-in-difference analysis of pharmacy claims of Part D enrollees and non-enrollees aged 67-79 years from 2005 to 2006. The final sample represented approximately 2.4 million unique subjects. Analyses were conducted separately for major therapeutic classes, limited to subjects filling at least one prescription within the class during 2005 and 2006, and adjusted for subject characteristics, prescription characteristics, socio-demographic characteristics measured through zipcode-linked Census data, baseline differences between Part D and non-Part D enrollees, and secular trends in generic use. RESULTS: Generic drugs accounted for 58% of total prescriptions. Among the entire group of beneficiaries, there was a trend of increased generic drug use in 13 out of 15 drug classes examined. However, after adjusting for potential confounders, the growth rate of generic drug use was lower among Part D enrollees than among non-enrollees; enrollees were slightly less likely to fill prescriptions for generic drugs vs. brand-name drugs in 2006 compared to 2005 (odds ratio 0.95, 95% confidence interval 0.94-0.95). CONCLUSIONS: Despite secular trends of increased utilization of generic drugs among both Part D enrollees and non-enrollees, the net impact of Part D among these beneficiaries was a modest decrease in the use of generic drugs. This finding, which is consistent with economic theory but contrary to several recent reports, highlights the complexity of assessing the impact of Part D on overall consumer welfare.

AB - BACKGROUND: Little information exists regarding the impact of Medicare Part D on generic drug use. OBJECTIVE: To examine changes in the use of generic prescriptions attributable to Part D among a sample of Medicare beneficiaries. DESIGN, PARTICIPANTS, AND MEASUREMENTS: Difference-in-difference analysis of pharmacy claims of Part D enrollees and non-enrollees aged 67-79 years from 2005 to 2006. The final sample represented approximately 2.4 million unique subjects. Analyses were conducted separately for major therapeutic classes, limited to subjects filling at least one prescription within the class during 2005 and 2006, and adjusted for subject characteristics, prescription characteristics, socio-demographic characteristics measured through zipcode-linked Census data, baseline differences between Part D and non-Part D enrollees, and secular trends in generic use. RESULTS: Generic drugs accounted for 58% of total prescriptions. Among the entire group of beneficiaries, there was a trend of increased generic drug use in 13 out of 15 drug classes examined. However, after adjusting for potential confounders, the growth rate of generic drug use was lower among Part D enrollees than among non-enrollees; enrollees were slightly less likely to fill prescriptions for generic drugs vs. brand-name drugs in 2006 compared to 2005 (odds ratio 0.95, 95% confidence interval 0.94-0.95). CONCLUSIONS: Despite secular trends of increased utilization of generic drugs among both Part D enrollees and non-enrollees, the net impact of Part D among these beneficiaries was a modest decrease in the use of generic drugs. This finding, which is consistent with economic theory but contrary to several recent reports, highlights the complexity of assessing the impact of Part D on overall consumer welfare.

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