Medicare Part D has been successful in reducing out-of-pocket costs for prescription drugs among older adults with diabetes, but some beneficiaries still experienced a coverage gap in 2011, study data show.
Yoon Jeong Choi, PhD, of the Research Institute of Nursing Science, Seoul National University College of Nursing in Korea, and colleagues in the United States used data from the Medical Expenditure Panel Survey (2000-2011) to assess out-of-pocket costs for prescription drugs among 4,664 Medicare beneficiaries with a diagnosis of diabetes (aged at least 65 years) compared with 2,938 younger, non-Medicare adults (aged 50-60 years) with the disease.
Before the implementation of Part D in 2006, the proportion of out-of-pocket to total pharmacy costs was higher for the Medicare group (51.4%) compared with that for the younger group (40.6%); after program implementation, out-of-pocket pharmacy costs were lower for the Medicare group (29.2%) compared with the younger group (37.7%).
Enrollment in Part D increased from 45.7% of Medicare beneficiaries in 2006 to 52.4% in 2011. The coverage gap, or “donut hole,” was experienced by 40.9% of the Medicare group in 2011, according to the researchers.
During the 6 years before Part D implementation, there was a 1.3% yearly decreasing trend for out-of-pocket pharmacy costs in the Medicare group. There was a reduction in the proportion of out-of-pocket costs for pharmacy expenditures by 13.5% in the Medicare group whether these beneficiaries were enrolled in Part D or not after implementation of the policy.
Compared with the younger group, out-of-pocket costs decreased by 19.4% in the Medicare group (P < .0001).
“Current efforts through the Affordable Care Act to reduce the coverage gap in Part D must be continued to decrease the proportion of those affected by the coverage gap,” the researchers wrote. “To reduce the risks of cost-related medication nonadherence, health care providers should enhance their understanding of Medicare Part D design and its coverage gap to offer the most affordable prescription drug options for their patients.” – by Amber Cox
Disclosure: The researchers report no relevant financial disclosures.