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Association of Medicare Part D Medication Out‐of‐Pocket Costs with Utilization of Statin Medications
Author(s) -
KaracaMandic Pinar,
Swenson Tami,
Abraham Jean M.,
Kane Robert L.
Publication year - 2013
Publication title -
health services research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.706
H-Index - 121
eISSN - 1475-6773
pISSN - 0017-9124
DOI - 10.1111/1475-6773.12022
Subject(s) - medicare part d , medicine , statin , prescription drug , percentile , medical prescription , medicare advantage , beneficiary , emergency medicine , health care , finance , business , pharmacology , statistics , economics , economic growth , mathematics
Objectives To examine the association between statin out‐of‐pocket ( OOP ) costs and utilization among the Medicare Part D population. Data Sources/Study Setting 2006–2008 administrative claims and enrollment data for the 5 percent Medicare sample. Study Design Sample included 346,583 beneficiary‐year observations of statin users enrolled in stand‐alone prescription drug plans, excluding low‐income subsidy recipients. We estimated the association between a plan's OOP statin costs and statin utilization using an instrumental variable approach to account for potential bias due to plan selection. Adherence was defined as percentage of days covered ( PDC ) of at least 80 percent. Plan OOP costs were constructed for a representative market basket of statin medications. Analyses controlled for demographic characteristics, cardiovascular disease risk, co‐morbidity presence, and regional characteristics. Principal Findings About 67 percent of the sample had a PDC of at least 80 percent. An increase in annual statin OOP from $200 (50th percentile) to $240 (75th percentile) was associated with a reduction in the rate of adherent beneficiaries from 67 percent to 56 percent ( p < .001). Conclusions Greater OOP costs for statins are associated with reductions in statin utilization.