Age disparities in prescription drug access and utilization within the Medicare program

Research Objective: To identify critical differences in prescription drug access among working age (18-64) and older (65+) Medicare beneficiaries.

Study Design: Secondary analysis of the 2005 Medicare Current Beneficiary Survey (MCBS) on Access to Care.

Population Studied: Medicare beneficiaries in the period immediately preceding implementation of the new Medicare prescription drug benefit.

Principal Findings: Younger beneficiaries had significantly higher rates of prescription nonadherance (28.9%) than older beneficiaries (11.6%). Younger and older beneficiaries had similar rates of prescription drug coverage (60.2% vs. 61.6%); but younger beneficiaries were more likely to have coverage through Medicaid (28.3% vs. 6.8%) and less likely to have private coverage (22.8% vs. 34.6%) or Medicare HMO coverage (6.4% vs. 12.3%). Younger beneficiaries were more likely to be in poor health (60.8% vs. 20.2%) and to have ADL limitations (29.8% vs. 15.3%) than older beneficiaries.

Conclusions: Younger Medicare beneficiaries are at greater risk of prescription nonadherance. This population is also more likely to report poor health, low incomes, and multiple impairments or chronic conditions.

Implications for Policy, Delivery or Practice: Adults under age 65 who receive Social Security Disability Income (SSDI) become eligible for Medicare 25 months after they begin to receive SSDI benefits. Younger beneficiaries are particularly vulnerable to rising drug costs, coverage gaps, and discontinuities in prescription regimens. The new Medicare prescription drug benefit should help reduce, but not eliminate, access barriers to prescribed medicines.