252167 Beta-blocker Drug Use in Medicare Part D Beneficiaries with Congestive Heart Failure

Wednesday, November 2, 2011: 10:30 AM

Christopher Powers, PharmD , Center for Strategic Planning, Centers for Medicare and Medicaid Services, Baltimore, MD
Anita Varghese-Thomas, PharmD , Center for Strategic Planning, Centers for Medicare and Medicaid Services, Baltimore, MD
Susannah Cafardi, MSW, LCSW, MPH , The Innovation Center, Centers for Medicare and Medicaid Services, Baltimore, MD
Congestive heart failure (CHF) affects approximately 17% of traditional fee-for-service Medicare beneficiaries. The Medicare Part D prescription drug program provides increased access to medications to treat this condition, including beta-adrenergic blocking agents (beta blockers). The purpose of this study was to describe the drug cost and use patterns of beta-blockers among Medicare Part D enrollees with CHF. In addition, adherence to beta-blocker was examined, including the relationship of adherence to health outcomes (hospitalizations and emergency room use).

Using a 20% sample of 2008 Medicare administrative claims data, aged beneficiaries with CHF were selected for the analysis if they had 12 months of Medicare Part A, Part B, and Part D coverage, and were alive at the end of the study year. The average number of prescription drug fills (30-day adjusted) and average costs per member per month (PMPM) were calculated overall, by demographics. Adherence to beta-blockers was examined using the proportion of days covered (PDC) methodology. Beneficiaries were classified as either adherent or not-adherent based on their PDC. The risk of all-cause hospitalizations and emergency room use within the study year was then compared between the two groups. Adherence was also examined in relation to out-of-pocket drug costs, overall pill burden (# of other drugs), number of other chronic conditions, and by Part D benefit phase.

Learning Areas:
Chronic disease management and prevention
Clinical medicine applied in public health
Conduct evaluation related to programs, research, and other areas of practice

Learning Objectives:
Describe the drug cost and use patterns of beta-adrenergic blocking agents (beta-blockers) in Medicare Part D beneficiaries with congestive heart failure. Analyze the relationship of adherence to beta-blockers in the Medicare Part D population on health outcomes, including hospitalizations and emergency room use.

Keywords: Prescription Drug Use Patterns, Adherence

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am a senior health services researcher at the Center for Medicare and Medicaid Services
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.