Effect of Prescription Drug Benefits on Cardiovascular Outcomes in the Elderly

2006年，美国实施了《医疗保险现代化法案》（Medicare Modernization Act），该法案扩大了医疗保险受益人的处方药覆盖范围，预计在未来10年将耗资7680亿美元。通过提供获得有效治疗的经济途径，改善获得药物益处的途径可能改善老年人心血管疾病的结局。然而，关于处方药覆盖范围对健康结果的影响的研究有限。此外，尽管研究发现黑人受试者使用降压、降脂和抗血小板药物的比例明显较低，但人们对处方药覆盖率作为种族和社会经济差异在心血管结局中的中介作用知之甚少。

In 2006, the United States implemented the Medicare Modernization Act, which expanded prescription drug coverage for Medicare beneficiaries at an estimated cost of $768 billion dollars over the next decade. Improved access to drug benefits may improve cardiovascular outcomes for the elderly by providing financial access to effective therapy. However, there is limited research about the impact of prescription drug coverage on health outcomes. In addition, although black enrollees have been found to have markedly lower use of antihypertensive, lipid-lowering and anti-platelet medications, little is known about the role of prescription drug coverage as a mediator of racial and socioeconomic disparities in cardiovascular outcomes. In this project, we will investigate the effect of prescription drug benefits on the use of appropriate secondary preventive medication and achievement of favorable clinical outcomes among Medicare managed care enrollees with cardiovascular disease. The project will also assess the role of prescription drug coverage in explaining racial and socioeconomic disparities in cardiovascular outcomes.