Disparities in prescription drug costs among working-age and older Medicare beneficiaries

Research Objective: To identify differences in total and out-of-pocket prescription drug costs among working age (18-64) and older (65+) Medicare beneficiaries.

Study Design: Secondary analysis of the 2004 Medicare Current Beneficiary Survey (MCBS) on Cost and Use.

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

Principal Findings: Younger beneficiaries have a greater likelihood of reporting poor health and multiple chronic conditions. Working-age beneficiaries exhibited higher prescription use than older Medicare recipients (34.7 annual prescribed medicine events vs. 26.8), and therefore incur higher total annual prescription costs ($2,558 vs. $1,670). Out-of-pocket prescription costs likely follow a similar trend. Due to higher costs, a greater proportion of working-age beneficiaries are at risk for falling into the "donut hole" built into the prescription drug benefit.

Conclusions: Younger Medicare beneficiaries are especially vulnerable to policy changes in prescription drug coverage.

Implications for Policy, Delivery or Practice: Adults under 65 who receive Social Security Disability Income (SSDI) become eligible for Medicare 25 months after they begin to receive SSDI benefits. Younger beneficiaries represent a vulnerable population in regards to rising drug costs and prescription coverage gaps. The new Medicare prescription drug benefit may help reduce, but it does not eliminate, cost barriers to prescribed medicines.