title: Impact of Medicare Part D on Racial Disparities in Adherence to Cardiovascular Medications Among the Elderly.
abstract: Medicare Part D improved medication adherence among the elderly, but to date, its effect on disparities in adherence remains unknown. We estimated Part D impact on racial/ethnic disparities in adherence to cardiovascular medications among seniors, using pooled data from the Medical Expenditure Panel Survey (2002-2010) on 14,221 Medicare recipients (65+ years) and 3,456 near-elderly controls (60-64 years). Study sample included White, Black, or Hispanic respondents who used at least one cardiovascular medication. Twelve-month adherence was measured as having an overall proportion of days covered ≥80%. Adherence disparities were defined according to the Institute of Medicine framework. Using difference-in-differences logistic regression, we found Part D to be associated with a 16-percentage-point decrease in the White-Hispanic disparity in overall adherence among seniors, net of the change among controls. Black-White disparities worsened only among men, by 21 percentage points. Increasing access and improving quality of medication use among disadvantaged seniors should remain a policy priority.
authors.affiliation: The University of Tennessee Health Science Center, Memphis, TN, USA mh992@drexel.edu.
authors.forename: Mustafa
authors.initials: M
authors.lastname: Hussein
authors.affiliation: The University of Tennessee Health Science Center, Memphis, TN, USA.
authors.forename: Teresa M
authors.initials: TM
authors.lastname: Waters
authors.affiliation: The University of Memphis, Memphis, TN, USA.
authors.forename: Cyril F
authors.initials: CF
authors.lastname: Chang
authors.affiliation: The University of Tennessee Health Science Center, Memphis, TN, USA.
authors.forename: James E
authors.initials: JE
authors.lastname: Bailey
authors.affiliation: Chapman University School of Pharmacy, Irvine, CA, USA.
authors.forename: Lawrence M
authors.initials: LM
authors.lastname: Brown
authors.affiliation: The University of Tennessee Health Science Center, Memphis, TN, USA.
authors.forename: David K
authors.initials: DK
authors.lastname: Solomon
mesh_terms: D001741:Black or African American / Q000706:statistics & numerical data; D000368:Aged; D002318:Cardiovascular Diseases / Q000188:drug therapy* / Q000208:ethnology; D005260:Female; D054625:Healthcare Disparities / Q000208:ethnology* / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D054524:Medicare Part D / Q000706:statistics & numerical data; D055118:Medication Adherence / Q000208:ethnology*; D008875:Middle Aged; D044469:Racial Groups / Q000706:statistics & numerical data*; D012737:Sex Factors; D014481:United States; D044465:White People / Q000706:statistics & numerical data; D016903:Drug Monitoring
keywords: MEPS; Medicare Part D; cardiovascular disease; medication adherence; racial disparities