Changes in Drug Utilization during a Gap in Insurance Coverage: An Examination of the Medicare Part D Coverage Gap
2011

Impact of Medicare Part D Coverage Gap on Drug Use

Sample size: 663850 publication 10 minutes Evidence: high

Author Information

Author(s): Jennifer M. Polinski, William H. Shrank, Haiden A. Huskamp, Robert J. Glynn, Joshua N. Liberman, Sebastian Schneeweiss

Primary Institution: Brigham and Women's Hospital

Hypothesis

Beneficiaries without financial assistance during the Medicare coverage gap will be more likely to discontinue medications and less likely to switch to cheaper alternatives.

Conclusion

The lack of financial assistance during the Medicare coverage gap led to a doubling in the rate of discontinuing essential medications but did not increase the likelihood of switching to cheaper drugs.

Supporting Evidence

  • Beneficiaries without financial assistance were twice as likely to discontinue essential medications.
  • Those without assistance were less likely to switch to cheaper drugs.
  • An estimated 18,000 additional patients discontinued medications annually due to the coverage gap.

Takeaway

When older people have to pay for their own medicine, they often stop taking it instead of switching to cheaper options.

Methodology

The study followed Medicare beneficiaries and compared drug discontinuation and switching rates between those with and without financial assistance during the coverage gap.

Potential Biases

Potential unmeasured confounding factors may affect the results.

Limitations

The study may not generalize to all Medicare beneficiaries as it focused on those enrolled in specific plans.

Participant Demographics

The study included community-dwelling, fee-for-service Medicare beneficiaries, primarily aged 65 and older.

Statistical Information

P-Value

p<0.05

Confidence Interval

95% CI 1.64–2.43

Statistical Significance

p<0.05

Digital Object Identifier (DOI)

10.1371/journal.pmed.1001075

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