Medicare Part D associated with reduction in nondrug medical spending

ScienceDaily (July 26, 2011) — Among elderly Medicare beneficiaries with limited prior drug coverage, implementation of Medicare Part D was associated with significant reductions in nondrug medical spending, such as for inpatient and skilled nursing facility care, according to a study in the July 27 issue of JAMA.See Also:Health & MedicinePharmacologyToday's HealthcareHealth PolicyPersonalized MedicineHIV and AIDSControlled SubstancesReferencePalliative carePharmaceutical companyDetoxClinical trial

"Implementation of the Medicare prescription drug benefit (Part D) in January 2006 was followed by increased medication use, reduced out-of-pocket costs, and improved adherence to essential medications for elderly persons. The effects of Part D on nondrug medical spending for Medicare beneficiaries have not been clearly defined," according to background information in the article.

J. Michael McWilliams, M.D., Ph.D., of Harvard Medical School and Brigham and Women's Hospital, Boston, and colleagues compared nondrug medical spending for traditional Medicare beneficiaries before and after the implementation of Part D. Nationally representative survey data and linked Medicare claims from 2004-2007 were used to compare nondrug medical spending before and after the implementation of Part D by self-reported generosity of prescription drug coverage (extent to which medications were mostly or completely covered) before 2006. Participants included 6,001 elderly Medicare beneficiaries from the Health and Retirement Study, including 2,538 with generous and 3,463 with limited drug coverage before 2006.

Adjusted total nondrug medical spending before implementation of Part D was consistently but not significantly higher for participants with limited drug coverage than for participants with generous drug coverage (7.6 percent relative difference). The researchers found that nondrug medical spending after Part D implementation was 3.9 percent lower for participants with limited prior drug coverage than for those with generous prior drug coverage, which was a significant differential