scholarly journals Does Closing the Donut Hole Reduce Financial Burdens Among Medicare Part D Beneficiaries?

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 906-906
Author(s):  
Yalu Zhang ◽  
Lan Liu ◽  
Jingjing Sun ◽  
Xinhui Zhang ◽  
Jiling Sun ◽  
...  
Keyword(s):  
Prescription Drugs ◽  
Medical Expenditure Panel Survey ◽  
Financial Burden ◽  
Medicare Part D ◽  
Medical Expenditure ◽  
Medicare Part ◽  
Absolute Poverty ◽  
Part D ◽  
Donut Hole ◽  
Financial Burdens

Abstract The Medicare Part D donut hole has been gradually closed since 2010. But it is still unclear how it has impacted the beneficiaries’ relative financial burdens, especially in the later stage of the closing plan. The measurement of catastrophic health expenditure induced by prescription drugs (CHE-Rx) reflects the relative financial burdens to beneficiaries’ household income, which bears more information than the measure of dollar-value expenses or the absolute poverty line used in prior studies. Using the Medical Expenditure Panel Survey 2008-2017 longitudinal national representative data and the method of difference-in-differences, this study found that the donut hole closing policy was associated with more usage of prescription drugs (b=2.84, p=0.023) and a higher likelihood of experiencing CHE-Rx (b=2.4%, p=0.011) among those who fell in the donut holes. Besides, the results show that the donut hole closing policy did not generate any immediate effects on prescription drug usage, CHE, and CHE-Rx. For the first time, this paper examined both the aggregated and marginal impact of the policy implementation, which had closed by an additional 35% between 2013 and 2017, on the relative financial burden among the beneficiaries.

scholarly journals Financial Burden for Patients With Chronic Myeloid Leukemia Enrolled in Medicare Part D Taking Targeted Oral Anticancer Medications

2017 ◽  
Vol 13 (2) ◽  
pp. e152-e162 ◽  
Author(s):  
Chan Shen ◽  
Bo Zhao ◽  
Lei Liu ◽  
Ya-Chen Tina Shih
Keyword(s):  
Chronic Myeloid Leukemia ◽  
Myeloid Leukemia ◽  
Financial Burden ◽  
Medicare Part D ◽  
Drug Costs ◽  
Medicare Part ◽  
High Price ◽  
Part D ◽  
Coverage Gap ◽  
Donut Hole

Purpose: The number of targeted oral anticancer medications (TOAMs) has grown rapidly in the past decade. The high cost of TOAMs raises concerns about the financial aspect of treatment, especially for patients enrolled in Medicare Part D plans because of the coverage gap. Methods: We identified patients with chronic myeloid leukemia (CML) who were new TOAM users from the SEER registry data linked with Medicare Part D data, from years 2007 to 2012. We followed these patients throughout the calendar year when they started taking the TOAMs and examined their out-of-pocket (OOP) payments and gross drug costs, taking into account their benefit phase, plan type, and cost share group. Results: We found that 726 (81%) of the 898 patients with CML who received TOAMs had reached the catastrophic phase of their Medicare Part D benefit within the year of medication initiation, with a large majority of patients reaching this phase in less than a month. Patients without subsidies showed a clear pattern of a spike in OOP payments when they began treatment with TOAMs. The OOP payment for patients with subsidies was substantially lower. The monthly gross drug costs were similar between patients with and without subsidies. Conclusion: Patients experience quick entry and exit from the coverage gap (also called the donut hole) as a result of the high price of TOAMs. Closing the donut hole will provide financial relief during the initial month(s) of treatment but will not completely eliminate the financial burden.

The Medicare Part D Coverage Gap, Prescription Use, and Expenditures

2018 ◽  
Vol 77 (5) ◽  
pp. 442-450 ◽  
Author(s):  
Aig Unuigbe
Keyword(s):  
Affordable Care Act ◽  
Financial Risk ◽  
Medicare Part D ◽  
Medicare Part ◽  
General Increase ◽  
Part D ◽  
Coverage Gap ◽  
Heterogeneous Effects ◽  
Drug Expenditures ◽  
Donut Hole

The Affordable Care Act has put in place policies to gradually close the Medicare Part D coverage gap (donut hole). I examine the effect of this gradual closure on total and out-of-pocket prescription drug expenditures, as well as the number of prescriptions filled. The analysis shows a general increase in prescription use. There are also heterogeneous effects, with higher total expenditure groups seeing a decrease in their out-of-pocket prescription expenditures. This suggests that closure of the “donut hole” has led to an increase in prescription use that was previously curtailed and had an impact on the financial risk faced by Medicare recipients. This has implications for trends in prescription use and Medicare expenditures in the future, as the coverage gap is closed further.

Medicare Part D is Associated With Reducing the Financial Burden of Health Care Services in Medicare Beneficiaries With Diagnosed Diabetes

Medical Care ◽  
2013 ◽  
Vol 51 (10) ◽  
pp. 888-893 ◽  
Author(s):  
Rui Li ◽  
Edward W. Gregg ◽  
Lawrence E. Barker ◽  
Ping Zhang ◽  
Fang Zhang ◽  
...  
Keyword(s):  
Health Care ◽  
Health Care Services ◽  
Financial Burden ◽  
Medicare Part D ◽  
Medicare Part ◽  
Medicare Beneficiaries ◽  
Part D ◽  
Care Services ◽  
Diagnosed Diabetes

Rising financial burden of targeted oral anticancer medications on the Medicare Part D program and its beneficiaries.

2016 ◽  
Vol 34 (15_suppl) ◽  
pp. 6625-6625
Author(s):  
Ya-Chen T. Shih ◽  
Ying Xu ◽  
Fabrice Smieliauskas ◽  
Lei Liu
Keyword(s):  
Financial Burden ◽  
Medicare Part D ◽  
Medicare Part ◽  
Part D

scholarly journals Impact of Medicare prescription drug (Part D) coverage expansion on utilisation and financial burden of benzodiazepines among older adults: an interrupted time series analysis

BMJ Open ◽  
2021 ◽  
Vol 11 (12) ◽  
pp. e053717
Author(s):  
Minghui Li ◽  
Jing Yuan ◽  
Chelsea Dezfuli ◽  
Z Kevin Lu
Keyword(s):  
Older Adults ◽  
Time Series ◽  
Financial Burden ◽  
Alternative Therapy ◽  
Interrupted Time Series ◽  
Medicare Part D ◽  
Annual Rate ◽  
Medicare Part ◽  
Part D ◽  
Coverage Expansion

ObjectiveBenzodiazepines were excluded from Medicare Part D coverage since its introduction in 2006. Part D expanded coverage for benzodiazepines in 2013. The objective was to examine the impact of Medicare Part D coverage expansion on the utilisation and financial burden of benzodiazepines in older adults.DesignInterrupted time series with a control group.SettingNationally representative sample.Participants53 150 468 users of benzodiazepines and 21 749 749 users of non-benzodiazepines (an alternative therapy) from the Medicare Current Beneficiary Survey between the pre-expansion (2006–2012) and post-expansion (2013–2017) periods.InterventionMedicare Part D coverage expansion on benzodiazepines.Primary and secondary outcome measuresAnnual rate of benzodiazepines and non-benzodiazepines, average number of benzodiazepines and non-benzodiazepines and average cost of benzodiazepines and non-benzodiazepines.ResultsAfter Medicare Part D coverage expansion, the level of the annual rate of benzodiazepines increased by 8.20% (95% CI: 6.07% to 10.32%) and the trend decreased by 1.03% each year (95% CI: −1.77% to −0.29%). The trend of the annual rate of non-benzodiazepines decreased by 0.72% each year (95% CI: −1.11% to −0.33%). For the average number of benzodiazepines, the level increased by 0.67 (95% CI: 0.52 to 0.82) and the trend decreased by 0.10 each year (95% CI: −0.15 to –0.05). For the average number of non-benzodiazepines, the level decreased by 0.11 (95% CI: −0.21 to –0.01) and the trend decreased by 0.04 each year (95% CI: −0.08 to –0.01). No significant level and trend changes were identified for the average cost of benzodiazepines and non-benzodiazepines.ConclusionsAfter Medicare Part D coverage expansion, there was a sudden increase in the utilisation of benzodiazepines and a decreasing trend in the long-term. The increase in the utilisation of benzodiazepines did not add a financial burden to older adults. As an alternative therapy, the utilisation of non-benzodiazepines decreased following the coverage expansion.

Impact of Medicare Part D on out-of-pocket drug costs and utilization for patients with cancer.

2013 ◽  
Vol 31 (31_suppl) ◽  
pp. 275-275
Author(s):  
Sheetal Mehta Kircher ◽  
Michael Johansen ◽  
Matthew M. Davis
Keyword(s):  
Prescription Drug ◽  
Prescription Drugs ◽  
Medicare Part D ◽  
Drug Costs ◽  
Medicare Part ◽  
Prescription Drug Coverage ◽  
Medicare Beneficiaries ◽  
Part D ◽  
Patients With Cancer ◽  
Per Capita

275 Background: Medicare Part D was designed to reduce out of pocket (OOP) costs for Medicare beneficiaries, but the extent to which this occurred for patients with cancer has not been measured. The aim of this study is to quantify the impact of Part D eligibility on OOP cost for prescription drugs and utilization for cancer patients. Methods: Differences-in-differences analyses were used to estimate the effects of Medicare Part D eligibility on OOP drug costs, by comparing 4 year periods before and after Part D implementation. Analyses were based on data from the publicly available Medical Expenditure Panel Survey, a nationally representative, all-payer sample of the United States non-institutionalized civilian population. Our analysis compared per-capita OOP burden between Medicare beneficiaries (age 65+) with cancer to near-elderly individuals age 55-64 years old with cancer. Results: 2,077 near-elderly individuals with cancer and 4,723 individuals with Medicare and cancer were included (total n=6,800), representing over 85 million people. Prescription drug coverage increased among individuals with Medicare from before Part D (39%) to after (65%); in contrast, prescription drug coverage among the near-elderly remained stable before vs. after Part D (82.4% vs. 81.4%). The mean per-capita OOP cost for Medicare beneficiaries with cancer before Part D was $1,111 (SE ±45) and decreased to $694 (±35) after implementation of Medicare Part D—a decline of 37%. Compared with changes in OOP drug costs for non-elderly patients with cancer over the same period, implementation of Medicare Part D was associated with a further reduction of $286 per person. OOP costs for cancer-associated drugs (i.e., antineoplastic, pain medications, anti-emetics) accounted for 6.5-11.1% of the total OOP cost with no significant trends between 2002-2010. Conclusions: The implementation of Medicare D has significantly reduced OOP prescription drug costs for seniors with cancer, beyond trends observed for younger patients. Considering prescription drugs for all medical conditions, cancer associated drugs compose a minority of the cost, highlighting that cancer patients have many comorbid conditions contributing to overall costs.

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