A practical physicians' guide to the Medicare drug benefit plan.
ABSTRACT Recent commentaries on Medicare Part D highlight both the early failings and the successes of the program. However, regardless of one's opinions about the program, Part D is a reality that millions of Medicare beneficiaries must address now and in the future. The ultimate economic, policy, and clinical success of the Medicare drug benefit plan depends on its transparency and ability to be navigated together by patients, physicians, and other parties. Although Medicare Part D is likely to evolve considerably in the future, it will continue to present elderly adults with numerous plan options and rules and therefore present persistent challenges for patients and physicians. By focusing on a few crucial aspects of Part D and taking advantage of available resources, physicians can simplify Part D for their patients, help them make informed decisions about enrollment and plan selection, and possibly help them save money with their current PDP. This may, in turn, reduce beneficiaries' out-of-pocket prescription costs, thereby improving patients' access to medications and possibly their medication adherence and health outcomes as well.
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ABSTRACT: Little is known about drug cost communications of Medicare Part D beneficiaries with chronic conditions such as diabetes. The purpose of this study is to assess Medicare Part D beneficiaries with diabetes' levels of communication with physicians regarding prescription drug costs; the perceived importance of these communications; levels of prescription drug switching due to cost; and self-reported cost-related medication non-adherence. Data were obtained from a cross-sectional survey (58% response rate) of 1,458 Medicare beneficiaries with diabetes who entered the coverage gap in 2006; adjusted percentages of patients with communication issues were obtained from multivariate regression analyses adjusting for patient demographics and clinical characteristics. Fewer than half of patients reported discussing the cost of medications with their physicians, while over 75% reported that such communications were important. Forty-eight percent reported their physician had switched to a less expensive medication due to costs. Minorities, females, and older adults had significantly lower levels of communication with their physicians regarding drug costs than white, male, and younger patients respectively. Patients with < $25 K annual household income were more likely than higher income patients to have talked about prescription drug costs with doctors, and to report cost-related non-adherence (27% vs. 17%, p < .001). Medicare Part D beneficiaries with diabetes who entered the coverage gap have low levels of communication with physicians about drug costs, despite the high perceived importance of such communication. Understanding patient and plan-level characteristics differences in communication and use of cost-cutting strategies can inform interventions to help patients manage prescription drug costs.BMC Health Services Research 06/2010; 10:164. DOI:10.1186/1472-6963-10-164 · 1.66 Impact Factor
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ABSTRACT: Optimizing medication adherence is a significant challenge for clinicians caring for older adults, particularly those with multiple chronic health conditions. Nearly half of all adults aged 65 or older take five or more medications regularly; however, adherence to chronic pharmacological therapies is often poor . Overall, 40% of older Medicare beneficiaries reported one or more forms of medication non-adherence in the previous year . Older patients are often more susceptible to the outcomes of poor adherence including worsening symptoms of disease and disease severity, increased hospital admissions, costs, and mortality [2, 3]. Older adults face many of the barriers to adherence discussed in previous chapters; however, age-related physical or cognitive impairments, multiple chronic health conditions, and/or complex treatment regimens frequently create distinct challenges related to adherence in this population. The aims of this chapter are to discuss special considerations related to medication adherence in older adults and to offer practical advice for improving medication adherence in this population.
Journal of the American Geriatrics Society 01/2007; 55(7):1106-1109. DOI:10.1111/j.1532-5415.2007.01286.x · 4.22 Impact Factor