title: The impact of Medicare Part D on out-of-pocket costs for prescription drugs, medication utilization, health resource utilization, and preference-based health utility.
abstract: OBJECTIVE
  To quantify the impact of Medicare Part D eligibility on medication utilization, emergency department use, hospitalization, and preference-based health utility among civilian noninstitutionalized Medicare beneficiaries.
  
  
  METHODS
  Difference-in-differences analyses were used to estimate the effects of Part D eligibility on health outcomes by comparing a 12-month period before and after Part D implementation using the Medical Expenditure Panel Survey. Models adjusted for sociodemographic characteristics and health status and compared Medicare beneficiaries aged 65 and older with near elderly aged 55-63 years old.
  
  
  RESULTS
  Five hundred and fifty-six elderly and 549 near elderly were included. After adjustment, Part D was associated with a U.S.$179.86 (p=.034) reduction in out-of-pocket costs and an increase of 2.05 prescriptions (p=.081) per patient year. The associations between Part D and emergency department use, hospitalizations, and preference-based health utility did not suggest cost offsets and were not statistically significant.
  
  
  CONCLUSIONS
  Although there was a substantial reduction in out-of-pocket costs and a moderate increase in medication utilization among Medicare beneficiaries during the first year after Part D, there was no evidence of improvement in emergency department use, hospitalizations, or preference-based health utility for those eligible for Part D during its first year of implementation.
authors: Global Health Economics, Baxter Healthcare Corporation, One Baxter Parkway, Deerfield, IL 60015, USA. xiaoqing_liu@baxter.com
authors: Frank Xiaoqing
authors: FX
authors: Liu
authors: G Caleb
authors: GC
authors: Alexander
authors: Stephanie Y
authors: SY
authors: Crawford
authors: A Simon
authors: AS
authors: Pickard
authors: Donald
authors: D
authors: Hedeker
authors: Surrey M
authors: SM
authors: Walton
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