Prescription drug costs for dually eligible people in a medicaid home- and community-based services program.
This study examined the prescription drug costs of Medicare beneficiaries participating in a Medicaid home- and community-based services (HCBS) program and discussed possible implications of providing a prescription drug benefit under Medicare. The study examined Medicaid pharmaceutical claims data using two random samples (n=766) of dually eligible Medicare beneficiaries in a HCBS program from four regions in Georgia. The average total monthly Medicaid prescription drug expenditure was determined. Annual prescription expenditures for this group averaged more than 1,500 dollars per person. Prescription drugs intended for the treatment of cancer and circulatory disorders combined to account for 61% of total program drug expenditures. Multivariate analysis found that drug expenditures were higher for those who died during the observation period, the young-old, Caucasians, and those who self-selected into the program. Higher drug expenditures for the self-selected group, even after frailty adjustments, suggest the presence of adverse selection. Medicare prescription drug benefit proposals that rely on voluntary enrollment may also experience adverse selection from frail, low-income beneficiaries.
Phillips
Victoria L
VL
Department of Health Policy and Management, Rollins School of Public Health of Emory University, Atlanta, Georgia 30322, USA. vphil01@sph.emory.edu
Atherly
Adam
A
D000368:Aged; D000369:Aged, 80 and over; D003153:Community Health Services / Q000191:economics; D016527:Drug Costs / Q000706:statistics & numerical data*; D011307:Drug Prescriptions / Q000191:economics* / Q000706:statistics & numerical data; D005252:Fees, Pharmaceutical / Q000706:statistics & numerical data*; D005260:Female; D016330:Frail Elderly; D005845:Georgia; D006699:Home Care Services / Q000191:economics; D006801:Humans; D008297:Male; D008484:Medicaid / Q000191:economics*; D008875:Middle Aged; D015999:Multivariate Analysis