Research Activities April 2013, No. 392
The proportion of high-risk drugs used by the elderly declined when they gained Medicare Part D coverage
Patients who moved from no drug coverage to Medicare Part D drug coverage increased their use of medications deemed Drugs to Avoid in the Elderly (DAE) from 15.72 percent to 17.61 percent. However, the proportion of DAE in overall drug use declined slightly from 3.01 percent to 1.98 percent, according to a new study. The proportion of drug-disease interactions remained stable. Medicare Part D, implemented in 2006, brought drug coverage to 28 million beneficiaries who either lacked it previously or had higher out-of-pocket costs, increased prescription drug use, and resulted in greater adherence to drug treatment for chronic diseases. The researchers suggest that to maximize the potential for Part D to improve the quality of medication use among older adults, additional changes to pharmacy benefit design (for example, cost-sharing) and health professional education may be necessary. Their findings were based on analysis of pharmacy and medical data from a large health insurer in Pennsylvania from 2004 to 2007, which had a variety of Medicare managed care plans. The study was funded in part by AHRQ (HS17695, HS18721, and HS19461).
More details are in "Medicare Part D and potentially inappropriate medication use in the elderly," by Julie M. Donohue, Ph.D., Zachary A. Marcum, Pharm.D., M.S., Wallid F. Gellad, M.D., M.P.H., and others in the September 2012 The American Journal of Managed Care 18(9), pp. e315-e322.