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AHRQ Research Studies
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Research Studies is a compilation of published research articles funded by AHRQ or authored by AHRQ researchers.
Results
1 to 25 of 75 Research Studies DisplayedAnderson KE, DiStefano MJ, Liu A
Incorporating added therapeutic benefit and domestic reference pricing into Medicare payment for expensive part B drugs.
The objective of this retrospective analysis was to identify expensive Part B drugs and to consider the evidence for each drug's added benefit in order to model a reimbursement policy for Medicare that integrates added benefit assessment and domestic reference pricing. Data were taken from a nationally representative sample of traditional Medicare Part B claims. The analysis showed that more than one-third of the expensive Part B drugs prescribed in 2019 offered low added benefit. The authors concluded that reference pricing based on added benefit assessment could be used to address the launch prices for expensive Part B drugs with low added benefit.
AHRQ-funded; HS000029.
Citation: Anderson KE, DiStefano MJ, Liu A .
Incorporating added therapeutic benefit and domestic reference pricing into Medicare payment for expensive part B drugs.
Value Health 2023 Sep; 26(9):1381-88. doi: 10.1016/j.jval.2023.05.018..
Keywords: Medicare, Payment, Medication, Healthcare Costs
Alpert A, Lakdawalla D, Sood N
Prescription drug advertising and drug utilization: the role of Medicare Part D.
The purpose of this paper was to explore how direct-to-consumer advertising (DTCA) for prescription drugs affects use by leveraging a large and plausibly exogenous shock to DTCA influenced by the introduction of Medicare Part D. Part D led to greater increases in advertising in geographic areas with greater concentrations of Medicare beneficiaries. The researchers explored the effect of this increase in advertising on non-elderly individuals to separate the effects of advertising from the direct effects of Part D. The study found that exposure to advertising resulted in large increases in treatment initiation and improved adherence to medication. Advertising also had substantial positive spillover effects on non-advertised generic drugs.
AHRQ-funded; HS025983.
Citation: Alpert A, Lakdawalla D, Sood N .
Prescription drug advertising and drug utilization: the role of Medicare Part D.
J Public Econ 2023 May; 221. doi: 10.1016/j.jpubeco.2023.104860..
Keywords: Communication, Medication, Medicare
Bond AM, Dean EB, Desai SM
The role of financial incentives in biosimilar uptake in Medicare: Evidence from the 340b program.
This study’s goal was to investigate whether the 340B Drug Pricing Program, which offers eligible hospitals substantial discounts on drug purchases, inhibits biosimilar uptake. Almost one-third of eligible US hospitals participate in the program. The authors used regression discontinuity design and two high-volume biologics with biosimilar competitors, filgrastim and infliximab to estimate that 340B program eligibility was associated with a 22.9-percentage-point reduction in biosimilar adoption. Additionally, 340B program eligibility was associated with 13.3 more biologic administrations annually per hospital and $17,919 more biologic revenue per hospital. The effect was found to be that it inhibited biosimilar uptake, possibly because of financial incentives that make reference drugs more profitable than biosimilar medications.
AHRQ-funded; HS027531.
Citation: Bond AM, Dean EB, Desai SM .
The role of financial incentives in biosimilar uptake in Medicare: Evidence from the 340b program.
Health Aff 2023 May; 42(5):632-41. doi: 10.1377/hlthaff.2022.00812..
Keywords: Medicare, Medication, Healthcare Costs
Levin JS, Komanduri S, Whaley C
Association between hospital-physician vertical integration and medication adherence rates.
This study’s goal was to test the association between vertical integration of primary care providers (PCPs) and adherence rates for anti-diabetics, renin angiotensin system antagonists (RASA), and statins. Data was extracted from Medicare Part B outpatient fee-for-service claims and Medicare Part D event data from 2014 to 2017. There was a 23% increase in the proportion of patients who had a vertically integrated PCP during the study period. Changes in adherence did not differ significantly between patients based on whether their PCP became integrated. However, among patients with PCPs who become integrated, there were significant decreases in patients who were above 80 years old, were Black, Asian, Hispanic, or Native America, and had greater comorbidities for all three classes.
AHRQ-funded; HS024067.
Citation: Levin JS, Komanduri S, Whaley C .
Association between hospital-physician vertical integration and medication adherence rates.
Health Serv Res 2023 Apr; 58(2):356-64. doi: 10.1111/1475-6773.14090.
Keywords: Medication, Patient Adherence/Compliance, Medicare, Primary Care
Growdon ME, Gan S, Yaffe K
New psychotropic medication use among Medicare beneficiaries with dementia after hospital discharge.
Hospital stays often trigger behavioral shifts in people with dementia (PWD), potentially leading to the prescription of psychotropic drugs despite their limited effectiveness and potential for harmful side-effects. The purpose of this study was to ascertain the prevalence of new psychotropic drug prescriptions in PWD living in the community after their discharge from the hospital, and within these new users, the percentage who continued their use for an extended duration. The researchers conducted a retrospective cohort study, utilizing a random selection of Medicare claims from 2017. The study included PWD hospital patients who were 68 years or older and covered by traditional and Part D Medicare. The primary outcome was the event of prescribing at the time of discharge psychotropic drugs including antipsychotics, sedative-hypnotics, antiepileptics, and antidepressants. The initiation was characterized as new prescriptions (from classes not utilized in the 180 days preceding admission) filled within a week of discharge from the hospital or skilled nursing facility. Extended use was defined as the percentage of new users who continued to refill the newly prescribed medications for more than 90 days post-discharge. The study population consisted of 117,022 hospitalized PWD with an average age of 81 years, with 63% being female. The study found that prior to admission, 63% were already using at least one psychotropic drug; 10% were using drugs from three or more psychotropic classes. These classes included antidepressants (44% pre-admission), antiepileptics (29%), sedative-hypnotics (21%), and antipsychotics (11%). The percentage of PWD discharged with new psychotropic prescriptions ranged from 1.9% (antipsychotics) to 2.9% (antiepileptics); 6.6% had at least one new class initiated. Among these new users, prolonged use varied from 36% (sedative-hypnotics) to 63% (antidepressants); across drug classes, prolonged use was observed in 51%. Factors associated with the initiation of new psychotropics included duration of hospital stay and delirium.
AHRQ-funded; HS026383.
Citation: Growdon ME, Gan S, Yaffe K .
New psychotropic medication use among Medicare beneficiaries with dementia after hospital discharge.
J Am Geriatr Soc 2023 Apr; 71(4):1134-44. doi: 10.1111/jgs.18161..
Keywords: Elderly, Medication, Medicare, Dementia, Neurological Disorders, Hospitalization
Glynn A, Hernandez I, Roberts ET
Consequences of forgoing prescription drug subsidies among low-income Medicare beneficiaries with diabetes.
This study’s objective was to estimate the take-up of the Medicare Part D Low-Income Subsidy (LIS) among Medicare beneficiaries with diabetes and examine differences in out-of-pocket costs and prescription drug use between LIS enrollees and LIS-eligible non-enrollees. Data from the Health and Retirement Study linked to Medicare administrative data from 2008 to 2016 was used. The authors first estimated LIS take-up stratified by income (≤100% of the Federal Poverty Level [FPL] and >100% to ≤150% of FPL). Second, to assess the consequences of forgoing the LIS among near-poor beneficiaries (incomes >100% to ≤150% of FPL), they conducted propensity score-weighted regression analyses to compare out-of-pocket costs, prescription drug use, and cost-related medication non-adherence among LIS enrollees and LIS-eligible non-enrollees. Among Medicare beneficiaries with diabetes, 68.1% of those considered near-poor (incomes >100% to ≤150% of FPL) received the LIS, compared to 90.3% of those with incomes ≤100% of FPL. Among near-poor beneficiaries, LIS-eligible non-enrollees incurred higher annual out-of-pocket drug spending ($518], filled 7.3 fewer prescriptions for diabetes, hypertension, and hyperlipidemia drugs, and were 8.9 percentage points more likely to report skipping drugs due to cost. all compared to LIS enrollees.
AHRQ-funded; HS026727.
Citation: Glynn A, Hernandez I, Roberts ET .
Consequences of forgoing prescription drug subsidies among low-income Medicare beneficiaries with diabetes.
Health Serv Res 2022 Oct;57(5):1136-44. doi: 10.1111/1475-6773.13990..
Keywords: Medication, Diabetes, Chronic Conditions, Low-Income, Medicare, Healthcare Costs
Oronce CIA, Arbanas JC, Leng M
Estimated wasteful spending on aducanumab dispensing in the U.S. Medicare population: a cross-sectional analysis.
The purpose of this study was to quantify the amount of aducanumab that is discarded because of vial dose size and calculate the potential Medicare savings that could be created by changing the vial size and drug weight to make dispensing more efficient and reduce the amount of discarded drug. The researchers calculated estimates for the monthly amount of discarded drug for each study participant, and then annualized the estimates. Costs were calculated using the 300 mg vial price, which is the larger of the two vial sizes currently available, and calculations were then made for simulated vials in three combinations (100 and 170 mg; 170 and 250mg; and 80mg, 170, and 300 mg.) Costs for each combination were then calculated. The study found that assuming a 10% drug uptake, the equivalent of between 132,398 and 694,258 vials of aducanumab would be discarded costing Medicare between $115.4 million and $604.9
million each year. If the 300 mg/3.0 ml vial was reduced to 100 mg/1.0 ml, Medicare savings would range between $70.9 and $369.0 million per year. The researchers concluded that reducing aducanumab vial size could decrease wasteful spending from discarded vials by over 60%.
million each year. If the 300 mg/3.0 ml vial was reduced to 100 mg/1.0 ml, Medicare savings would range between $70.9 and $369.0 million per year. The researchers concluded that reducing aducanumab vial size could decrease wasteful spending from discarded vials by over 60%.
AHRQ-funded; HS026498.
Citation: Oronce CIA, Arbanas JC, Leng M .
Estimated wasteful spending on aducanumab dispensing in the U.S. Medicare population: a cross-sectional analysis.
J Am Geriatr Soc 2022 Sep;70(9):2714-18. doi: 10.1111/jgs.17891..
Keywords: Medicare, Healthcare Costs, Medication
Anderson KE, Alexander GC, Ma C
Medicare Advantage coverage restrictions for the costliest physician-administered drugs.
This study examined the use of step therapy, prior authorization, and Part D formulary exclusion by 4 large Medicare Advantage (MA) insurers to manage 20 physician-administered drugs with the highest total Medicare expenditures (top 20 drugs). The authors used data from United Healthcare, CVS/Aetna, Humana, and Kaiser plans to create a database of 2020 Part B coverage restrictions and conducted a retrospective analysis of 2018-2020 Part D formularies. For each insurer, they calculated the number of top 20 physician-administered drugs subject to prior authorization and step therapy. Among the 4 insurers, 16 physician-administered drugs were covered on all or some of the Part D formularies in 2018, which decreased to 6 in 2020.
AHRQ-funded; HS000029.
Citation: Anderson KE, Alexander GC, Ma C .
Medicare Advantage coverage restrictions for the costliest physician-administered drugs.
Am J Manag Care 2022 Jul;28(7):e255-e62. doi: 10.37765/ajmc.2022.89184..
Keywords: Medicare, Health Insurance, Medication
Anderson KE, Polsky D, Dy S
Prescribing of low- versus high-cost Part B drugs in Medicare Advantage and traditional Medicare.
The purpose of this study was to compare Medicare Advantage (MA) coverage with traditional Medicare (TM) coverage as it relates to whether MA is associated with greater efficiency of prescribing Part B drugs. The authors sampled 20% of all 2016 outpatient and carrier TM claims and MA encounter records and Master Beneficiary Summary File data and analyzed whether MA enrollees more often received the low-cost Part B drug compared to TM enrollees. Four clinical scenarios were evaluated where multiple, similarly effective drugs exist: (1) anti-VEGF agents to treat macular degeneration, (2) bone resorption inhibitors for osteoporosis, (3) bone resorption inhibitors for malignant neoplasms, and (4) intravenous iron for iron deficiency anemia. The researchers estimated spending differences if TM prescribing aligned with MA prescribing and evaluated whether differences between MA and TM prescribing patterns were due to differences in the hospitals and provider practices who treat MA and TM enrollees or differences in how those hospitals and provider practices engage with their MA vs TM patients. The researchers found that more MA enrollees received the low-cost drug vs. TM enrollees in all 4 clinical scenarios, and that if TM prescribing matched that of ME prescribing, there would be a spending savings of 6% to 20% for each of the 4 scenarios. The study concluded that in 4 clinical scenarios in which similarly or equally effective treatment options exist, MA enrollees were more likely than TM enrollees to receive low-cost Part B drugs.
AHRQ-funded; HS000029.
Citation: Anderson KE, Polsky D, Dy S .
Prescribing of low- versus high-cost Part B drugs in Medicare Advantage and traditional Medicare.
Health Serv Res 2022 Jun;57(3):537-47. doi: 10.1111/1475-6773.13912..
Keywords: Medication, Medicare, Healthcare Costs
Behr CL, Joynt Maddox KE, Meara E
Anti-SARS-CoV-2 monoclonal antibody distribution to high-risk Medicare beneficiaries, 2020-2021.
The authors assessed how the limited supply of monoclonal antibodies (mAbs) therapy was allocated to patients at highest risk of severe disease. They found that, among non-hospitalized Medicare beneficiaries with a COVID-19 diagnosis between November 2020 and August 2021, only 7.2% received mAb therapy. In many cases, patients at the highest risk of severe disease were the least likely to receive mAb therapy, with extreme variation geographically. Their analysis did not account for patient vaccination status or observed disease severity, which could influence clinicians’ decisions.
AHRQ-funded; HS024075.
Citation: Behr CL, Joynt Maddox KE, Meara E .
Anti-SARS-CoV-2 monoclonal antibody distribution to high-risk Medicare beneficiaries, 2020-2021.
JAMA 2022 Mar 8;327(10):980-83. doi: 10.1001/jama.2022.1243..
Keywords: COVID-19, Medicare, Medication
Hussaini SMQ, Gupta A, Anderson KE
Utilization of filgrastim and infliximab biosimilar products in Medicare Part D, 2015-2019.
This research letter describes a cross-sectional study that investigated whether the use of biosimilar drugs was associated with reduced spending in Medicare Part D. This study evaluated utilization trends for filgrastim which is a drug used to treat cancer, and infliximab, a drug used for autoimmune conditions such as rheumatoid arthritis. From 2015 to 2019, filgrastim claims increased by 15% and infliximab increased by 41%. Annual spending share on filgrastim biosimilars went from 2% in 2015 to 56% in 2019. The share for infliximab increased from less than 1% to 3.6%. Total annual Medicare Part D spending on filgrastim decreased by only 7% from 2015 to 2019, while spending on infliximab total annual Part D spending increased by 17% despite biosimilar competition.
AHRQ-funded; HS000029.
Citation: Hussaini SMQ, Gupta A, Anderson KE .
Utilization of filgrastim and infliximab biosimilar products in Medicare Part D, 2015-2019.
JAMA Netw Open 2022 Mar;5(3):e221117. doi: 10.1001/jamanetworkopen.2022.1117..
Keywords: Medicare, Medication
Duvalyan A, Pandey A, Vaduganathan M
Trends in anticoagulation prescription spending among Medicare Part D and Medicaid beneficiaries between 2014 and 2019.
Researchers examined contemporary direct oral anticoagulant (DOAC) spending patterns within Medicare Part D and Medicaid between 2014 and 2019. They found that, although overall DOAC spending is increasing, DOAC use may be associated with lower downstream medical expenditures compared with warfarin stemming from decreased risk of major bleeding and stroke and reduced drug monitoring.
AHRQ-funded; HS022418.
Citation: Duvalyan A, Pandey A, Vaduganathan M .
Trends in anticoagulation prescription spending among Medicare Part D and Medicaid beneficiaries between 2014 and 2019.
J Am Heart Assoc 2021 Dec 21;10(24):e022644. doi: 10.1161/jaha.121.022644..
Keywords: Blood Thinners, Medication, Medicare, Medicaid, Healthcare Costs
Roberts ET, Glynn A, Donohue JM
The relationship between take-up of prescription drug subsidies and Medicaid among low-income Medicare beneficiaries.
In this study, the investigators examined take-up of the Low-Income Subsidy (LIS) and Medicaid among Medicare beneficiaries who qualified for both programs. They went beyond prior analyses that reported average enrollment by program by 1.) examining whether LIS take-up mirrored Medicaid enrollment at income levels where individuals qualified for limited Medicaid benefits that had low take-up rates and 2.) highlighting opportunities for policy reforms to increase participation in both programs.
AHRQ-funded; HS026727.
Citation: Roberts ET, Glynn A, Donohue JM .
The relationship between take-up of prescription drug subsidies and Medicaid among low-income Medicare beneficiaries.
J Gen Intern Med 2021 Sep;36(9):2873-76. doi: 10.1007/s11606-020-06241-y..
Keywords: Medicaid, Medicare, Medication, Low-Income, Health Insurance
McCoy RG, Van Houten HK, Deng Y
Comparison of diabetes medications used by adults with commercial insurance vs Medicare Advantage, 2016 to 2019.
Investigators sought to compare trends in initiation of treatment with GLP-1RA, SGLT2i, and DPP-4i by older adults with type 2 diabetes insured by Medicare Advantage vs commercial health plans. They found that Medicare Advantage beneficiaries may be less likely than commercially insured beneficiaries to be treated with newer medications to lower glucose levels, with greater disparities among lower-income patients. They recommended further investigation of nonclinical factors contributing to treatment decisions and efforts to promote greater equity in diabetes management.
AHRQ-funded; HS025164.
Citation: McCoy RG, Van Houten HK, Deng Y .
Comparison of diabetes medications used by adults with commercial insurance vs Medicare Advantage, 2016 to 2019.
JAMA Netw Open 2021 Feb;4(2):e2035792. doi: 10.1001/jamanetworkopen.2020.35792..
Keywords: Elderly, Diabetes, Chronic Conditions, Medication, Medicare, Health Insurance, Disparities, Low-Income
Feder SL, Canavan ME, Wang S
Patterns of opioid prescribing among Medicare Advantage beneficiaries with pain and cardiopulmonary conditions.
This study’s objective was to compare patterns of opioid prescribing among older adults reporting pain with cardiopulmonary conditions, cancer, or both. Data from the Surveillance, Epidemiology, and End Results-Medicare Health Outcomes Survey resource linked to Medicare Part D prescription claims was used to identify patients who self-reported moderate- to-severe pain interference with daily activities. Patients included were stratified by 1) self-reported history of cardiopulmonary conditions; 2) were within five years of cancer diagnosis; 3) had both conditions; or 4) neither. Of 10,516 patients identified, 1758 had cardiopulmonary conditions, 3383 cancer, 2861 both, and 2514 neither: with 46% aged 75 or more, 65% non-Hispanic white, and 10% non-Hispanic black. At the time of the survey, 1627 (15.5%) received opioids. Adjusted proportions of opioid use were similar for all conditions, with 14% for cardiopulmonary conditions only, 17% with cancer only, and 17% for both conditions. Patients with neither condition had a 13.1% opioid use rate.
AHRQ-funded; HS022882; HS025164.
Citation: Feder SL, Canavan ME, Wang S .
Patterns of opioid prescribing among Medicare Advantage beneficiaries with pain and cardiopulmonary conditions.
J Palliat Med 2021 Feb;24(2):195-204. doi: 10.1089/jpm.2020.0193..
Keywords: Elderly, Opioids, Medication, Practice Patterns, Medicare
Caram MEV, Oerline MK, Dusetzina S
Adherence and out-of-pocket costs among Medicare beneficiaries who are prescribed oral targeted therapies for advanced prostate cancer.
The authors investigated coping and material measures of the financial hardship of abiraterone and enzalutamide among patients with advanced prostate cancer with Medicare Part D coverage. They found substantial variations in the adherence rate and out-of-pocket payments, with sociodemographic patient and regional factors found to be associated with both aspects.
AHRQ-funded; HS025707.
Citation: Caram MEV, Oerline MK, Dusetzina S .
Adherence and out-of-pocket costs among Medicare beneficiaries who are prescribed oral targeted therapies for advanced prostate cancer.
Cancer 2020 Dec 1;126(23):5050-59. doi: 10.1002/cncr.33176..
Keywords: Patient Adherence/Compliance, Medicare, Cancer: Prostate Cancer, Cancer, Medication, Healthcare Costs
Hambley BC, Anderson KE, Shanbhag SP
Payment incentives and the use of higher-cost drugs: a retrospective cohort analysis of intravenous iron in the Medicare population.
Researchers examined prescribing patterns in the context of intravenous (IV) iron, for which multiple similarly safe and efficacious formulations exist, with wide variations in price. Using Medicare data, they found an increase in the dispensing of a higher-priced IV iron formulation associated with a shortage of a less expensive drug that persisted once the shortage ended. They concluded that their findings in IV iron have broader implications for Part B drug payment policy because the price of the drug determines the physician and health system payment.
AHRQ-funded; HS000029.
Citation: Hambley BC, Anderson KE, Shanbhag SP .
Payment incentives and the use of higher-cost drugs: a retrospective cohort analysis of intravenous iron in the Medicare population.
Am J Manag Care 2020 Dec;26(12):516-22. doi: 10.37765/ajmc.2020.88539..
Keywords: Elderly, Medication, Medicare, Payment, Healthcare Costs, Practice Patterns
Romman AN, Hsu CM, Chou LN
Opioid prescribing to Medicare Part D enrollees, 2013-2017: shifting responsibility to pain management providers.
This study looked at trends in opioid prescribing frequency to Medicare Part D enrollees from 2013 to 2017 by medical specialty and provider type. The authors analyzed opioid claims and prescribing trends for specialties accounting for ≥1% of all opioid claims. Pain management specialists increased Medicare Part D opioid claims by 27.3% to 1,140 mean claims per provider in 2017. Physical medicine and rehabilitation providers increased claims by 16.9% to 511 mean claims per provider in 2017. All other medical specialties decreased opioid claims during this period, with emergency medicine decreasing the most (-19.9%) and orthopedic surgery (-16%) dropping opioid claims the most of all the other specialties. Overall physician decrease was -5.2%. However opioid claims among dentists (+5.6%) and nonphysician providers (+10.2%) increased during this period.
AHRQ-funded; HS020642.
Citation: Romman AN, Hsu CM, Chou LN .
Opioid prescribing to Medicare Part D enrollees, 2013-2017: shifting responsibility to pain management providers.
Pain Med 2020 Nov 7;21(7):1400-07. doi: 10.1093/pm/pnz344..
Keywords: Elderly, Opioids, Medication, Medicare, Pain, Chronic Conditions, Practice Patterns
Hill SC, Miller GE, Ding Y
AHRQ Author: Hill SC, Miller GE, Ding Y
Net spending on retail specialty drugs grew rapidly, especially for private insurance and Medicare Part D.
This study examined net spending trends on retail specialty drugs from 2010 to 2017. Spending has been difficult to measure due to proprietary rebate payments by manufacturers by insurers, pharmacy benefit managers and state Medicaid agencies. The authors incorporated those rebates into their research. They found that specialty drugs accounted for 37.7% of retail and mail-order prescription spending net of rebates in 2016-17. The spending net of rebates tripled for Medicare Part D beneficiaries and more than doubled for people with private insurance from 2010 to 2017. Medicaid net spending of rebates had a slower increase.
AHRQ-authored.
Citation: Hill SC, Miller GE, Ding Y .
Net spending on retail specialty drugs grew rapidly, especially for private insurance and Medicare Part D.
Health Aff 2020 Nov;39(11):1970-76. doi: 10.1377/hlthaff.2019.01830..
Keywords: Medical Expenditure Panel Survey (MEPS), Healthcare Costs, Medication, Medicare, Health Insurance
Socal MP, Anderson KE, Sen A
Biosimilar uptake in Medicare Part B varied across hospital outpatient departments and physician practices: the case of filgrastim.
The purpose of this study was to examine the uptake of filgrastim-sndz (Zarxio), the first biosimilar to launch in the United States, in the Medicare Part B fee-for-service program from its launch in September 2015 to December 2017 and compare characteristics of patients and facilities that used filgrastim-sndz or originator filgrastim (Neupogen). The investigators concluded that uptake of biosimilar filgrastim in the Medicare Part B program occurred despite multiple challenges to the adoption of biosimilars in the US market, suggesting that substantial potential savings could be generated by improving biosimilar uptake.
AHRQ-funded; HS000029.
Citation: Socal MP, Anderson KE, Sen A .
Biosimilar uptake in Medicare Part B varied across hospital outpatient departments and physician practices: the case of filgrastim.
Value Health 2020 Apr;23(4):481-86. doi: 10.1016/j.jval.2019.12.007..
Keywords: Medicare, Practice Patterns, Medication, Healthcare Costs
Tseng CW, Masuda C, Chen R
Impact of higher insulin prices on out-of-pocket costs in Medicare Part D.
In this study, the investigators examined how patients’ out-of-pocket costs for insulin would have dropped from 2014 to 2019 due to Part D policy changes and whether higher insulin prices offset these potential savings. The authors concluded that efforts to reduce patients’
out-of-pocket cost by closing the Medicare Part D coverage gap were largely negated by higher insulin prices.
out-of-pocket cost by closing the Medicare Part D coverage gap were largely negated by higher insulin prices.
AHRQ-funded; HS024227.
Citation: Tseng CW, Masuda C, Chen R .
Impact of higher insulin prices on out-of-pocket costs in Medicare Part D.
Diabetes Care 2020 Apr;43(4):e50-e51. doi: 10.2337/dc19-1294..
Keywords: Medication, Healthcare Costs, Medicare, Health Insurance, Policy
Wickwire EM, Vadlamani A, Tom SE
Economic aspects of insomnia medication treatment among Medicare beneficiaries.
The purpose of this study was to examine economic aspects of insomnia and insomnia medication treatment among a nationally representative sample of older adult Medicare beneficiaries. A total of 23,079 beneficiaries with insomnia were included. Of these, 5,154 (22%) received >1 fills for an FDA-approved insomnia medication following insomnia diagnosis. For both treated and untreated individuals, healthcare utilization and costs increased during the 12 months prior to diagnosis. Insomnia treatment was associated with significantly increased ED visits and prescription fills in the year following insomnia diagnosis.
AHRQ-funded; HS024560.
Citation: Wickwire EM, Vadlamani A, Tom SE .
Economic aspects of insomnia medication treatment among Medicare beneficiaries.
Sleep 2020 Jan;43(1):pii: zsz192. doi: 10.1093/sleep/zsz192..
Keywords: Medication, Sleep Problems, Medicare, Healthcare Costs
Hu T, Decker SL, Chou SY
AHRQ Author: Decker SL
The impact of health insurance expansion on physician treatment choice: Medicare Part D and physician prescribing.
Researchers tested the effect of the introduction of Medicare Part D on physician prescribing behavior using data on physician visits from the National Ambulatory Medical Care Survey (NAMCS). Subjects were patients aged 60-69. The researchers found a 32% increase in the number of prescription drugs prescribed or continued per visit and a 46% increase in the number of generic drugs prescribed or continued for the elderly after the introduction of Medicare Part D.
AHRQ-authored.
Citation: Hu T, Decker SL, Chou SY .
The impact of health insurance expansion on physician treatment choice: Medicare Part D and physician prescribing.
https://www.ncbi.nlm.nih.gov/pubmed/28168448.
Keywords: Medical Expenditure Panel Survey (MEPS), Health Insurance, Medicare, Medication, Practice Patterns, Elderly
Solotke MT, Ross JS, Shah ND
Medicare prescription drug plan formulary restrictions after postmarket FDA black box warnings.
This study investigated whether Medicare prescription drug plan formulary restrictions were enacted after the FDA issued black box warnings for drugs that are now considered problematic. Investigators looked at drugs that were issued new or updated black box warnings from 2008 to 2015 and found there was only a 3% decrease in drug formularies providing unrestricted prescriptions.
AHRQ-funded; HS025164.
Citation: Solotke MT, Ross JS, Shah ND .
Medicare prescription drug plan formulary restrictions after postmarket FDA black box warnings.
J Manag Care Spec Pharm 2019 Nov;25(11):1201-17. doi: 10.18553/jmcp.2019.25.11.1201..
Keywords: Medication, Medicare, Policy
Hart A, Gustafson SK, Wey A
The association between loss of Medicare, immunosuppressive medication use, and kidney transplant outcomes.
The purpose of this study was to determine the association between the timing of Medicare loss and immunosuppressive medication fills and kidney allograft loss. Findings indicated that the medication possession ratio (MPR) was lower for recipients with early or late Medicare loss compared with no coverage loss for all immunosuppressive medication types. When recipients were matched by age, posttransplant timing of Medicare loss, and donor risk, the hazard of allograft loss was significantly higher after Medicare loss, with no difference in the hazard for on-time Medicare loss.
AHRQ-funded; HS024527.
Citation: Hart A, Gustafson SK, Wey A .
The association between loss of Medicare, immunosuppressive medication use, and kidney transplant outcomes.
Am J Transplant 2019 Jul;19(7):1964-71. doi: 10.1111/ajt.15293..
Keywords: Kidney Disease and Health, Medicare, Medication, Outcomes, Patient-Centered Outcomes Research, Transplantation