Effect of Medicare Part D and insurance type on Medicare beneficiary access to prescription medication and use of prescription cost-saving measures.
OBJECTIVE
To examine how prescription drug access and use of prescription cost-saving measures changed after Medicare Part D was implemented and to determine their predictors in Medicare beneficiaries with different insurance types.


METHODS
Repeated cross-sectional study.


METHODS
United States in 2005 and 2007.


METHODS
Medicare beneficiaries aged 65 years or older (n = 1,220 in 2005 and n = 1,024 in 2007).


METHODS
Web-based surveys using nonprobability samples.


METHODS
Access to prescription drugs and use of seven costsaving measures.


RESULTS
Significantly fewer participants stopped taking a prescription because of cost, applied to an assistance program, received free prescription samples, and had limited prescription access in 2007 compared with 2005. Use of cost-saving measures by Medicare Part D patients was more comparable with that by uninsured participants than patients with employer-based drug coverage. One-third of all participants and almost one-half of Medicare Part D participants had requested a less expensive prescription. Among those participants, 70% received a less expensive prescription and most thought it worked about the same as the more expensive prescription.


CONCLUSIONS
Prescription drug access and use of cost-saving measures improved somewhat following the implementation of Medicare Part D, but some access problems continued to exist for Part D participants. Requests for less expensive prescriptions were common and frequently resulted in satisfactory switches.
College of Pharmacy, University of Iowa, Iowa City, IA 52242, USA. julieurmie@uiowa.edu
Julie M
JM
Urmie
Karen B
KB
Farris
William R
WR
Doucette
Amber M
AM
Goedken
D000368:Aged; D000369:Aged, 80 and over; D017046:Cost Savings; D003430:Cross-Sectional Studies; D016527:Drug Costs; D005252:Fees, Pharmaceutical; D005260:Female; D006297:Health Services Accessibility / Q000706:statistics & numerical data*; D006801:Humans; D007356:Insurance, Pharmaceutical Services; D008297:Male; D054524:Medicare Part D; D055553:Prescription Drugs / Q000191:economics* / Q000627:therapeutic use; D014481:United States
D055553:Prescription Drugs