Will the Medicare prescription drug benefit eliminate cost barriers for older adults with diabetes mellitus?
Will the Medicare prescription drug benefit eliminate cost barriers for older adults with diabetes mellitus?
复制标题
医疗保险处方药福利是否会消除老年糖尿病患者的成本障碍？
DOI：
10.1111/j.1532-5415.2006.00663.x
复制
发表时间：
2006
影响因子：
6.3
通讯作者：
Schwartz,JSanford
中科院分区：
文献类型：
--
作者：
Tjia,Jennifer;Schwartz,JSanford
试验：确定符合参加标准医疗保险D部分药物福利的糖尿病（DM）老年人的比例，他们将超过最初的2，250美元保险限额，并确定降糖药选择对超过保险限额风险的影响。设计：横断面调查。设置：参加2001年医疗支出小组调查（MEPS）的美国家庭中的成年人的全国代表性样本。参与者：符合参加标准医疗保险D部分药物福利的65岁及以上糖尿病诊断的个人。测量：MEPS处方药文件中报告的调整至2006年美元的处方药使用和支出。调查加权逻辑回归模型被用来估计的几率，每年的药物支出超过$2，250，控制低血糖类型，社会人口特征，慢性疾病，和health status.RESULTS：估计有320万老年人与糖尿病符合标准药物福利填写处方在2001年，约64%的药物支出超过$2，250在2006年调整美元。超过初始覆盖范围限制的比例因使用的降糖药物类型而异，从使用传统降糖药物的60%到使用新型降糖药物的75%以上。合并症较多和健康状况较差的患者超过初始覆盖范围limit.CONCLUSION的风险更大：很大比例的老年糖尿病患者可能超过标准医疗保险D部分药物福利下的初始覆盖范围限制，并产生显着的自付支出。
OBJECTIVES:To determine the proportion of older people with diabetes mellitus (DM) eligible to enroll in the standard Medicare Part D drug benefit who will exceed the initial $2,250 coverage limit and to determine the effect of hypoglycemic choice on risk of exceeding the coverage limit.DESIGN:Cross‐sectional survey.SETTING:Nationally representative sample of adults living in United States households participating in the 2001 Medical Expenditure Panel Survey (MEPS).PARTICIPANTS:Individuals aged 65 and older with a diagnosis of DM eligible to enroll in the standard Medicare Part D drug benefit.MEASUREMENTS:Prescription medication use and expenditures adjusted to 2006 U.S. dollars as reported in the MEPS prescribed medicine file. Survey‐weighted logistic regression models were used to estimate the odds of annual medication expenditures exceeding $2,250, controlling for hypoglycemic type, sociodemographic characteristics, chronic conditions, and health status.RESULTS:Of the estimated 3.2 million elderly people with DM eligible for the standard drug benefit filling a prescription in 2001, approximately 64% had medication expenditures in excess of $2,250 in 2006 adjusted dollars. The proportion exceeding the initial coverage limit varied by type of hypoglycemic drug used from 60% of those using traditional hypoglycemics to more than 75% of those using novel hypoglycemics. Patients with more comorbidities and poorer health status were at greater risk of exceeding the initial coverage limit.CONCLUSION:A large proportion of older adults with DM may exceed the initial coverage limit under the standard Medicare Part D drug benefit and incur significant out‐of‐pocket spending.