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APHA Scientific Session and Event Listing

Tami Swenson, School of Public Health, University of Minnesota, 55 Willey Hall, 225 19th Avenue S, Minneapolis, MN 55455, (612) 626-8492, jrinsky@asph.org

Objective: To determine the effectiveness of providing drug coverage to the Medicare population, it is important to establish the baseline rates of prescription medication underuse prior to the implementation of Medicare Part D.

Methods: Data from the 1996-2004 Medicare Current Beneficiary Survey (MCBS) Access to Care module are used to examine prescription medication underuse for the Medicare population. Underuse is defined as prescription medications not acquired by the beneficiary during the previous 12 months. Cross-sectional and longitudinal underuse rates are examined, and logistic regression is used to determine measures associated with underuse, such as socioeconomic traits, chronic conditions, and drug coverage.

Results: Cross-sectional findings show that cost reasons are the predominant factor for nonadherence and that the rate of underuse has increased from less than 3 percent to approximately 4.5 percent currently. Comparisons of the longitudinal cohorts, however, show a steady rate of approximately 10 percent reporting underuse at least once during the four-year panel. Moreover, the longitudinal rates demonstrate that over 85 percent of those reporting underuse do so for only a single year. Logistic regression results show expected patterns of association between socioeconomic conditions and drug coverage policies with the likelihood of prescription medication underuse.

Conclusions: Previous studies of prescription medication underuse in the Medicare population have been based on cross-sectional surveys and have assumed that reported underuse was a regular cost-saving practice rather than episodic. The longitudinal findings in this study, however, suggest that underuse is typically an isolated event and related to expected predictors.

Learning Objectives: At the conclusion of the session, the participant will be able to

• Identify the primary reasons for prescription medication underuse by the Medicare population.
• Assess Medicare beneficiary characteristics associated with underuse.
• Evaluate the impact of drug coverage policies on the likelihood of prescription drug underuse.

Keywords: Medicare, Prescription Drug Use Patterns

Presenting author's disclosure statement:

Not Answered