BACKGROUND: It is not known what effect the increased use of prescription drugs by enrollees in Medicare Part D has had on spending for other medical care. METHODS: We compared spending for prescription drugs and other medical care 2 years before the implementation of Part D in January 2006 with such expenditures 2 years after the program's implementation in four groups of elderly beneficiaries: Medicare Advantage enrollees with stable, uncapped, employer-based drug coverage throughout the study period (no-cap group), those who had no previous drug coverage, and those who had previous limited benefits (with either a $150 or a $350 quarterly cap) before they were covered by Part D in 2006. RESULTS: Between December 2005 and December 2007, as compared with the increase in the no-cap group, the increase in total monthly drug spending was $41 higher (95% confidence interval [CI], $33 to $50) (74%) among enrollees with no previous drug coverage, $27 higher (95% CI, $20 to $34) (27%) among those with a previous $150 quarterly cap, and $13 higher (95% CI, $8 to $18) (11%) among those with a previous $350 cap. The use of both lipid-lowering and antidiabetic medications rose in the groups with no or minimal previous drug coverage. As compared with expenditures in the no-cap group, monthly medical expenditures (excluding drugs) were $33 lower (95% CI, $29 to $37) in the group with no previous coverage and $46 lower (95% CI, $29 to $63) in the group with a previous $150 quarterly cap, whereas medical spending was $30 higher (95% CI, $25 to $36) in the group with a previous $350 cap. CONCLUSIONS: Enrollment in Medicare Part D was associated with increased spending on prescription drugs. Groups that had no or minimal drug coverage before the implementation of Part D had reductions in other medical spending that approximately offset the increased spending on drugs, but medical spending increased in the group that had more generous previous coverage. 2009 Massachusetts Medical Society
BACKGROUND: It is not known what effect the increased use of prescription drugs by enrollees in Medicare Part D has had on spending for other medical care. METHODS: We compared spending for prescription drugs and other medical care 2 years before the implementation of Part D in January 2006 with such expenditures 2 years after the program's implementation in four groups of elderly beneficiaries: Medicare Advantage enrollees with stable, uncapped, employer-based drug coverage throughout the study period (no-cap group), those who had no previous drug coverage, and those who had previous limited benefits (with either a $150 or a $350 quarterly cap) before they were covered by Part D in 2006. RESULTS: Between December 2005 and December 2007, as compared with the increase in the no-cap group, the increase in total monthly drug spending was $41 higher (95% confidence interval [CI], $33 to $50) (74%) among enrollees with no previous drug coverage, $27 higher (95% CI, $20 to $34) (27%) among those with a previous $150 quarterly cap, and $13 higher (95% CI, $8 to $18) (11%) among those with a previous $350 cap. The use of both lipid-lowering and antidiabetic medications rose in the groups with no or minimal previous drug coverage. As compared with expenditures in the no-cap group, monthly medical expenditures (excluding drugs) were $33 lower (95% CI, $29 to $37) in the group with no previous coverage and $46 lower (95% CI, $29 to $63) in the group with a previous $150 quarterly cap, whereas medical spending was $30 higher (95% CI, $25 to $36) in the group with a previous $350 cap. CONCLUSIONS: Enrollment in Medicare Part D was associated with increased spending on prescription drugs. Groups that had no or minimal drug coverage before the implementation of Part D had reductions in other medical spending that approximately offset the increased spending on drugs, but medical spending increased in the group that had more generous previous coverage. 2009 Massachusetts Medical Society
Authors: Jeanne M Madden; Amy J Graves; Fang Zhang; Alyce S Adams; Becky A Briesacher; Dennis Ross-Degnan; Jerry H Gurwitz; Marsha Pierre-Jacques; Dana Gelb Safran; Gerald S Adler; Stephen B Soumerai Journal: JAMA Date: 2008-04-23 Impact factor: 56.272
Authors: R Tamblyn; R Laprise; J A Hanley; M Abrahamowicz; S Scott; N Mayo; J Hurley; R Grad; E Latimer; R Perreault; P McLeod; A Huang; P Larochelle; L Mallet Journal: JAMA Date: 2001 Jan 24-31 Impact factor: 56.272
Authors: Lesley H Curtis; Truls Østbye; Veronica Sendersky; Steve Hutchison; Peter E Dans; Alan Wright; Raymond L Woosley; Kevin A Schulman Journal: Arch Intern Med Date: 2004 Aug 9-23
Authors: Michele Heisler; Kenneth M Langa; Elizabeth L Eby; A Mark Fendrick; Mohammed U Kabeto; John D Piette Journal: Med Care Date: 2004-07 Impact factor: 2.983
Authors: Gregory C Pope; John Kautter; Randall P Ellis; Arlene S Ash; John Z Ayanian; Lisa I Lezzoni; Melvin J Ingber; Jesse M Levy; John Robst Journal: Health Care Financ Rev Date: 2004
Authors: Haiden A Huskamp; David G Stevenson; A James O'Malley; Stacie B Dusetzina; Susan L Mitchell; Barbara J Zarowitz; Michael E Chernew; Joseph P Newhouse Journal: Med Care Date: 2013-10 Impact factor: 2.983
Authors: John Hsu; Vicki Fung; Jie Huang; Mary Price; Richard Brand; Rita Hui; Bruce Fireman; William H Dow; John Bertko; Joseph P Newhouse Journal: Health Aff (Millwood) Date: 2010-10-28 Impact factor: 6.301
Authors: Yuting Zhang; Judith R Lave; Joseph P Newhouse; Julie M Donohue Journal: J Gerontol B Psychol Sci Soc Sci Date: 2009-12-14 Impact factor: 4.077
Authors: Ross J Simpson; James Signorovitch; Howard Birnbaum; Jasmina Ivanova; Cristina Connolly; Yohanne Kidolezi; Andreas Kuznik Journal: Mayo Clin Proc Date: 2009-12 Impact factor: 7.616
Authors: Vicki Fung; Carol M Mangione; Jie Huang; Norman Turk; Elaine S Quiter; Julie A Schmittdiel; John Hsu Journal: Health Serv Res Date: 2009-12-30 Impact factor: 3.402