title: Who enrolls in the Medicare Part D prescription drug benefit program? Medication use among patients with heart failure.
abstract: BACKGROUND
  Dispensing data from Medicare Part D standalone prescription drug plans are now available, but characteristics of enrollees with heart failure have not been well described.
  
  
  RESULTS
  We identified 81 874 patients with prevalent heart failure as of January 1, 2010, in a nationally representative 5% sample of Medicare beneficiaries. We classified patients according to enrollment in a Medicare Part D plan as of January 1, 2010. Demographic characteristics, comorbid conditions, and prescriptions were compared by enrollment status. A total of 49 252 (60.2%) were enrolled in a Medicare Part D plan as of January 1. Enrollees were more often women, black, and of lower socioeconomic status. Enrollees with heart failure more often filled prescriptions for loop diuretics than angiotensin-converting enzyme inhibitors or angiotensin receptor blockers, β-blockers, or aldosterone antagonists. During the first 4 months of 2010, 5444 (12.3%) reached the coverage gap, and 566 (1.3%) required catastrophic coverage beyond the gap.
  
  
  CONCLUSIONS
  Medicare beneficiaries with heart failure differ significantly according to enrollment in Part D prescription drug plans and represent a population underrepresented in clinical efficacy trials. Many face the coverage gap, and few select Medicare Part D plans that provide coverage during the gap. Linking Medicare Part D event data with clinical registries could help to determine whether eligible enrollees are undertreated for heart failure.
authors.affiliation: Duke Clinical Research Institute, Duke University School of Medicine, Durham, NC.
authors.forename: Zubin J
authors.initials: ZJ
authors.lastname: Eapen
authors.forename: Bradley G
authors.initials: BG
authors.lastname: Hammill
authors.forename: Soko
authors.initials: S
authors.lastname: Setoguchi
authors.forename: Kevin A
authors.initials: KA
authors.lastname: Schulman
authors.forename: Eric D
authors.initials: ED
authors.lastname: Peterson
authors.forename: Adrian F
authors.initials: AF
authors.lastname: Hernandez
authors.forename: Lesley H
authors.initials: LH
authors.lastname: Curtis
mesh_terms: D000369:Aged, 80 and over; D004363:Drug Utilization / Q000706:statistics & numerical data*; D005260:Female; D006333:Heart Failure / Q000188:drug therapy*; D006801:Humans; D008297:Male; D054524:Medicare Part D / Q000706:statistics & numerical data*; D055553:Prescription Drugs; D014481:United States
chemical_list: D055553:Prescription Drugs
keywords: Medicare Part D; heart failure; outcome assessment (health care)
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