Back to Annual Meeting Page		American Public Health Association 133rd Annual Meeting & Exposition December 10-14, 2005 Philadelphia, PA

Abstract #113433

Musetta Leung, MS¹, Donald S. Shepard, PhD², William B. Stason, MD², and Grant Ritter, PhD². (1) Heller School for Social Policy and Management, Brandeis University, MS 035, 415 South Street, Waltham, MA 02454-9110, (2) Schneider Institute for Health Policy, Heller School for Social Policy and Management, Brandeis University, MS 035, 415 South Street, Waltham, MA 02454-9110, 781-736-3975, Shepard@Brandeis.edu

Research Objective: Concerns over prescription drug affordability has prompted states to adopt measures that increase access among low-income populations. This study evaluated the predictors of prescription drug skimping, defined as skipping doses or not filling prescriptions for financial reasons, among elders enrolled in pharmacy assistance programs (PAPs). Study Design: In mid-2002, Illinois and Wisconsin implemented “SeniorCare,” the states' Pharmacy Assistance Waivers (Pharmacy Plus) program that provided low-income persons aged 65 years and older with Medicaid-funded prescription drug assistance. Enrollees were surveyed to assess drug utilization, affordability, and insurance. Multivariate logistic regressions were used to assess predictors of skimping before and after enrollment in SeniorCare. Population Studied: A random sample of community-dwelling SeniorCare enrollees was interviewed via telephone in Spring 2004, with a response rate of 61%. All enrollees with non-missing data were included in the analysis (n=1,734). Results: Having more self-reported illnesses was associated with a higher probability of only skimping in the pre-SeniorCare period (OR=1.3, CI=1.13-1.43), while being less poor (>160% FPL), older, having better self-perceived health, and having private health insurance were associated with a lower chance of pre-SeniorCare skimping (OR=0.70, CI=0.52-0.92; OR=0.94, CI=0.92-0.96; OR=0.77, CI=0.67-0.89; OR=0.73, CI=0.55-0.97, respectively). After enrolling in SeniorCare, individuals who reported a prior-month out-of-pocket (OOP) prescription drug cost of $50 to $199 and $200 to $400 were two times more likely to continue skimping medicines compared to those with OOP of less than $50, but being older and White lowered the likelihood of skimping (OR=0.96, CI=0.94-0.99; OR=0.49, CI=0.33-0.72, respectively).

Learning Objectives:

• At the conclusion of the session, the participant will be able to list factors that impact the likelihood of medication skimping, despite the implementation of state pharmacy assistance programs.

Keywords: Prescription Drug Use Patterns, Cost Issues

Presenting author's disclosure statement:

I wish to disclose that I have NO financial interests or other relationship with the manufactures of commercial products, suppliers of commercial services or commercial supporters.

Recorded presentation