title: Veterans' Pharmacy and Health Care Utilization Following Implementation of the Medicare Part D Pharmacy Benefit.
abstract: We examined associations between enrollment in Medicare Part D pharmacy benefits and changes in medication acquisition from Department of Veterans Affairs (VA) pharmacies. We included all women and a random 10% sample of men who were VA enrollees, ≥65 years old as of January 1, 2004, and alive through December 2007. We used difference-in-differences models with propensity score weighting to examine changes in medication acquisition between 2005 (before Part D was implemented) and 2007 (after Part D implementation) for veterans who were or were not Part D enrolled. Of 231,716 veterans meeting inclusion criteria, 49,881 (21.5%) were enrolled. While 30-day medication supplies decreased from 26.2 to 23.4 for enrolled veterans, they increased from 36.6 to 37.4 for nonenrolled veterans (difference-in-differences: -4.0, p < .001). Reductions in 30-day supplies were greater among veterans who were required to pay VA copayments for some or all medications and who used VA and Medicare outpatient services.
authors.affiliation: 1 Center of Innovation for Complex Chronic Healthcare, Edward Hines Jr. Veterans Affairs Hospital, Hines, IL, USA.|2 Loyola University Chicago Department of Public Health Sciences, Maywood, IL, USA.
authors.forename: Kevin T
authors.initials: KT
authors.lastname: Stroupe
authors.affiliation: 1 Center of Innovation for Complex Chronic Healthcare, Edward Hines Jr. Veterans Affairs Hospital, Hines, IL, USA.|3 University of Illinois at Chicago, Chicago, IL, USA.
authors.forename: Lauren
authors.initials: L
authors.lastname: Bailey
authors.affiliation: 4 Veterans Affairs Pittsburgh Healthcare System, Pittsburgh, PA, USA.|5 University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.
authors.forename: Walid F
authors.initials: WF
authors.lastname: Gellad
authors.affiliation: 1 Center of Innovation for Complex Chronic Healthcare, Edward Hines Jr. Veterans Affairs Hospital, Hines, IL, USA.|3 University of Illinois at Chicago, Chicago, IL, USA.
authors.forename: Katie
authors.initials: K
authors.lastname: Suda
authors.affiliation: 1 Center of Innovation for Complex Chronic Healthcare, Edward Hines Jr. Veterans Affairs Hospital, Hines, IL, USA.
authors.forename: Zhiping
authors.initials: Z
authors.lastname: Huo
authors.affiliation: 1 Center of Innovation for Complex Chronic Healthcare, Edward Hines Jr. Veterans Affairs Hospital, Hines, IL, USA.
authors.forename: Rachael
authors.initials: R
authors.lastname: Martinez
authors.affiliation: 6 Veterans Affairs Pharmacy Benefit Management Services, Edward Hines Jr. VA Hospital, Hines IL.
authors.forename: Muriel
authors.initials: M
authors.lastname: Burk
authors.affiliation: 6 Veterans Affairs Pharmacy Benefit Management Services, Edward Hines Jr. VA Hospital, Hines IL.
authors.forename: Francesca
authors.initials: F
authors.lastname: Cunningham
authors.affiliation: 1 Center of Innovation for Complex Chronic Healthcare, Edward Hines Jr. Veterans Affairs Hospital, Hines, IL, USA.|7 Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, USA.|8 Northwestern University, Chicago IL, USA.
authors.forename: Bridget M
authors.initials: BM
authors.lastname: Smith
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008297:Male; D054524:Medicare Part D / Q000706:statistics & numerical data*; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data*; D010594:Pharmacies / Q000706:statistics & numerical data*; D014481:United States; D014493:United States Department of Veterans Affairs; D014728:Veterans / Q000706:statistics & numerical data*
keywords: Medicare; pharmacy; utilization; veteran