title: Medicare Part D coverage gap: race, gender, and cost-related medication nonadherence.
abstract: This study examined whether the Medicare Part D coverage gap directly and indirectly affects the relationship between race, gender, and cost-related nonadherence (CRN). Using a nationally representative sample (N = 1,157), this study found that racial disparities in CRN existed under Medicare Part D. However, reaching the coverage gap mediated differences in CRN between older Blacks and Whites. The coverage gap was associated with CRN and poorer health and lower income were associated with CRN after accounting for coverage gap status. Findings highlight the need to help vulnerable populations avoid CRN and for greater consideration of racial inequities in future policy decisions.
authors.affiliation: a School of Social Work, University at Buffalo, The State University of New York , Buffalo , New York , USA.
authors.forename: Louanne
authors.initials: L
authors.lastname: Bakk
mesh_terms: D001741:Black or African American / Q000706:statistics & numerical data; D000368:Aged; D000369:Aged, 80 and over; D003365:Costs and Cost Analysis / Q000706:statistics & numerical data; D003430:Cross-Sectional Studies; D005260:Female; D054625:Healthcare Disparities / Q000191:economics / Q000208:ethnology; D006801:Humans; D019458:Insurance Coverage / Q000706:statistics & numerical data*; D008297:Male; D054524:Medicare Part D; D055118:Medication Adherence / Q000208:ethnology; D012737:Sex Factors; D014481:United States; D044465:White People / Q000706:statistics & numerical data; D016903:Drug Monitoring
keywords: Medicare Part D; Racial and gender disparities; coverage gap; nonadherence due to cost