Jon Wilson Mercer PharmD Candidate C/O 2012
description
Transcript of Jon Wilson Mercer PharmD Candidate C/O 2012
![Page 1: Jon Wilson Mercer PharmD Candidate C/O 2012](https://reader035.fdocuments.in/reader035/viewer/2022062501/56815b4a550346895dc92a5b/html5/thumbnails/1.jpg)
Implementation of Medicare Part D and Nondrug Medical Spending for Elderly Adults
With Limited Prior Drug CoverageHaiden Huskamp PhD, J. Michael McWilliams MD, Alan Zaslavsky
• Jon Wilson• Mercer PharmD Candidate• C/O 2012
![Page 2: Jon Wilson Mercer PharmD Candidate C/O 2012](https://reader035.fdocuments.in/reader035/viewer/2022062501/56815b4a550346895dc92a5b/html5/thumbnails/2.jpg)
Medicare Part D
• Introduced in January 2006
• Increased medication use
• Reduced out of pocket costs
• Adherence to essential medications for elderly persons
![Page 3: Jon Wilson Mercer PharmD Candidate C/O 2012](https://reader035.fdocuments.in/reader035/viewer/2022062501/56815b4a550346895dc92a5b/html5/thumbnails/3.jpg)
Before Part D
• Limits on drug benefits for elderly adults were associated with greater use of acute care
![Page 4: Jon Wilson Mercer PharmD Candidate C/O 2012](https://reader035.fdocuments.in/reader035/viewer/2022062501/56815b4a550346895dc92a5b/html5/thumbnails/4.jpg)
Objective
• To assess changes in nondrug medical spending following the introduction of Part D for Medicare beneficiaries with limited prior drug coverage.
• Study cohort(2004-2007) and control cohort(2002-2005)****To assess changes in spending when not affected by Part D
![Page 5: Jon Wilson Mercer PharmD Candidate C/O 2012](https://reader035.fdocuments.in/reader035/viewer/2022062501/56815b4a550346895dc92a5b/html5/thumbnails/5.jpg)
Study Cohort
• Longitudinal survey data and Medicare claims from 2004-2007.– Data before and after implementation of Part D– 2538 patients with generous drug coverage before
2006– 3463 patients with limited drug coverage before
2006
![Page 6: Jon Wilson Mercer PharmD Candidate C/O 2012](https://reader035.fdocuments.in/reader035/viewer/2022062501/56815b4a550346895dc92a5b/html5/thumbnails/6.jpg)
Control Cohort
• Survey Participants from 2002-2005– 2537 with generous drug coverage– 3451 with limited drug coverage
![Page 7: Jon Wilson Mercer PharmD Candidate C/O 2012](https://reader035.fdocuments.in/reader035/viewer/2022062501/56815b4a550346895dc92a5b/html5/thumbnails/7.jpg)
Study Population
• Inclusion– Enrolled in traditional Medicare at the beginning of
2002/2004
• Exclusion– Patients who became eligible for Medicare before age 65– Military Veterans who received care from VA
Criteria the same for both Study and Control Cohorts
![Page 8: Jon Wilson Mercer PharmD Candidate C/O 2012](https://reader035.fdocuments.in/reader035/viewer/2022062501/56815b4a550346895dc92a5b/html5/thumbnails/8.jpg)
Nondrug Medical Spending
• Assessed quarterly • Inpatient and skilled nursing facility
institutional services cover by Part A• Physician and ancillary services covered by
Part B• Since Part B covers inpatient and outpatient
physician services, outpatient data was analyzed to distinguish differences
![Page 9: Jon Wilson Mercer PharmD Candidate C/O 2012](https://reader035.fdocuments.in/reader035/viewer/2022062501/56815b4a550346895dc92a5b/html5/thumbnails/9.jpg)
Results
• Nondrug medical spending after Part D was 3.9% lower for participants with limited prior drug coverage than those with generous coverage.
• -$306/quarterly between observed and expected
![Page 10: Jon Wilson Mercer PharmD Candidate C/O 2012](https://reader035.fdocuments.in/reader035/viewer/2022062501/56815b4a550346895dc92a5b/html5/thumbnails/10.jpg)
Results
![Page 11: Jon Wilson Mercer PharmD Candidate C/O 2012](https://reader035.fdocuments.in/reader035/viewer/2022062501/56815b4a550346895dc92a5b/html5/thumbnails/11.jpg)
Results
![Page 12: Jon Wilson Mercer PharmD Candidate C/O 2012](https://reader035.fdocuments.in/reader035/viewer/2022062501/56815b4a550346895dc92a5b/html5/thumbnails/12.jpg)
Control Cohort Results
• Differences in nondrug medical spending between participants with limited vs. generous drug coverage in 2002 were similar before and after January 1, 2004.
![Page 13: Jon Wilson Mercer PharmD Candidate C/O 2012](https://reader035.fdocuments.in/reader035/viewer/2022062501/56815b4a550346895dc92a5b/html5/thumbnails/13.jpg)
Control Cohort Results
![Page 14: Jon Wilson Mercer PharmD Candidate C/O 2012](https://reader035.fdocuments.in/reader035/viewer/2022062501/56815b4a550346895dc92a5b/html5/thumbnails/14.jpg)
Conclusion
• Implementation of Part D was associated with differential reductions in nondrug medical spending for Medicare beneficiaries with limited prior drug coverage.
![Page 15: Jon Wilson Mercer PharmD Candidate C/O 2012](https://reader035.fdocuments.in/reader035/viewer/2022062501/56815b4a550346895dc92a5b/html5/thumbnails/15.jpg)
Comment
• Increased medication use and adherence achieved through Part D have been associated with decreased spending for nondrug medical care.
• Drug coverage gains may have also reduced early complications of acute conditions.
![Page 16: Jon Wilson Mercer PharmD Candidate C/O 2012](https://reader035.fdocuments.in/reader035/viewer/2022062501/56815b4a550346895dc92a5b/html5/thumbnails/16.jpg)
Level of Evidence