title: Medication strategies used by Medicare beneficiaries who reach the Part D standard drug-benefit threshold.
abstract: OBJECTIVE
  The mechanisms used by Medicare beneficiaries who reached their Part D drug-benefit threshold to cope with the costs of prescription drugs were evaluated.
  
  
  METHODS
  A retrospective review of integrated medical and pharmacy electronic records and a mail survey were utilized. Members of a Medicare Advantage plan continuously enrolled in 2006 in either a standard drug-benefit plan who reached their threshold by October 1, 2006 (study group) or a retiree drug subsidy plan without a threshold but by October 1, 2006, had reached the threshold in total drug spend (control group) were included. Data on members' cost-lowering medication strategies, demographics, and socioeconomic status were analyzed.
  
  
  RESULTS
  Of the 1,472 questionnaires mailed, 622 (42%) were completed. Respondents in the study group were more likely than control respondents to be male, be married, own a home, report lower health status, and have a household income of <$30,000 (p < 0.05). There were no significant differences in age, race or ethnicity, and diagnoses between groups. Study group respondents were three times more likely than control group respondents to use a cost-lowering strategy (p < 0.001). Predictors of increased risk of using a medication cost-lowering strategy included study group assignment, age, health status, education, income, and purchase of a second-generation antipsychotic (p < 0.05).
  
  
  CONCLUSIONS
  Respondents in the study group were three times more likely than respondents in the control group to report using a medication cost-lowering strategy. Respondents who were younger and had limited prescription drug coverage, lower household income, higher educational status, and poorer health status were at increased risk of adopting a cost-lowering strategy.
authors.affiliation: Department of Pharmacy, Kaiser Permanente Colorado, Aurora, CO 80011-9045, USA.
authors.forename: Amber
authors.initials: A
authors.lastname: Cronk
authors.forename: Tammy L
authors.initials: TL
authors.lastname: Humphries
authors.forename: Thomas
authors.initials: T
authors.lastname: Delate
authors.forename: Denese
authors.initials: D
authors.lastname: Clark
authors.forename: Barbara
authors.initials: B
authors.lastname: Morris
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D014487:Centers for Medicare and Medicaid Services, U.S.; D003363:Cost Control / Q000379:methods; D016527:Drug Costs / Q000706:statistics & numerical data*; D011307:Drug Prescriptions / Q000191:economics*; D005260:Female; D006304:Health Status; D006801:Humans; D007356:Insurance, Pharmaceutical Services / Q000191:economics*; D008297:Male; D054524:Medicare Part D / Q000191:economics*; D012189:Retrospective Studies; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D014481:United States