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Has Medicare Part D Reduced Racial/Ethnic Disparities in Prescription Drug Use and Spending?
Author(s) -
Mahmoudi Elham,
Jensen Gail A.
Publication year - 2014
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 - 10.1111/1475-6773.12099
Subject(s) - medical prescription , medicine , ethnic group , prescription drug , medicare part d , demography , medical expenditure panel survey , gerontology , health care , health insurance , pharmacology , political science , sociology , law
Objective To evaluate whether M edicare Part D has reduced racial/ethnic disparities in prescription drug utilization and spending. Data Nationally representative data on white, A frican A merican, and H ispanic M edicare seniors from the 2002–2009 M edical E xpenditure P anel S urvey are analyzed. Five measures are examined: filling any prescriptions during the year, the number of prescriptions filled, total annual prescription spending, annual out‐of‐pocket prescription spending, and average copay level. Study Design We apply the I nstitute of M edicine's definition of a racial/ethnic disparity and adopt a difference‐in‐difference‐in‐differences ( DDD ) estimator using a multivariate regression framework. The treatment group consists of Medicare seniors, the comparison group, adults without M edicare aged 55–63 years. Principal Findings Difference‐in‐difference‐in‐differences estimates suggest that for A frican A mericans Part D increased the disparity in annual spending on prescription drugs by $258 ( p = .011), yet had no effect on other measures of prescription drug disparities. For H ispanics, DDD estimates suggest that the program reduced the disparities in annual number of prescriptions filled, annual total and out‐of‐pocket spending on prescription drugs by 2.9 ( p = .077), $282 ( p = .019) and $143 ( p < .001), respectively. Conclusion Medicare Part D had mixed effects. Although it reduced Hispanic/white disparities related to prescription drugs among seniors, it increased the A frican A merican/white disparity in total annual spending on prescription drugs.