Applying the 2003 Beers update to Medicaid Medicare enrollees

• Published in: International journal of pharmaceutical and healthcare marketing Vol. 2; no. 4; pp. 257 - 272
• Main Authors: Blackwell, Steven A., Ciborowski, Gary M., Baugh, David K., Montgomery, Melissa A.
• Format: Journal Article
• Language: English
• Published: Bradford Emerald Group Publishing Limited 21.11.2008
• Subjects: Age groups; Beneficiaries; Drug use; Government programs; Health insurance; Hispanic Americans; Medicaid; Medicare; Nursing homes; Older people; Patients; Pharmacy; Population; Prescription drugs; Statistical analysis; United States > US; Elderly people; Health insurance; United States of America; Medical prescriptions; Patient care
• ISSN: 1750-6123; 1750-6131
• DOI: 10.1108/17506120810922312

Purpose - The purpose of this paper is to examine rates of potentially inappropriate prescribing in a population dually eligible for Medicare and Medicaid using the new 2003 Fick update, which revises the previous 1997 Beers list.Design methodology approach - Cross sectional retrospective review of 2003 Centers for Medicare and Medicaid Service (CMS) Medicaid Pharmacy claims data. Claims data submitted for outpatient and nursing home residents for elderly enrollees dually eligible for Medicare and Medicaid were analyzed. Potentially inappropriate drug use was assessed using the 2003 Fick update to the previous 1997 Beers list. Inappropriate use was identified based on these criteria for drugs independent of diagnosis.Findings - Of enrollees with drug use, 34 percent received an inappropriate drug per the 1997 Beers list; 47 percent per the 2003 Fick update. Hispanics had the highest percentage of drug recipients receiving an inappropriate drug in the Northeast region per the 2003 Fick update. Within therapeutic category, the number of inappropriate genitourinary products dispensed to total genitourinary products ranked the highest at 20 percent per the 2003 Fick update.Practical implications - This study examines variations in Beers drug use in the elderly dually eligible Medicare and Medicaid population in 2003 by applying the 2003 Fick et al. update of the 1997 Beers list to one of the nation's largest sources of person-specific data on prescribed drugs. Inappropriate use was identified for drugs independent of diagnosis. Of enrollees with drug use, 34 percent received an inappropriate drug per the 1997 Beers list; 47 percent per the 2003 Fick update. Within therapeutic category, the number of inappropriate genitourinary products dispensed to total genitourinary products ranked the highest at 20 percent per the 2003 Fick update. The paper's findings provide evidence that the potential use of inappropriate drugs in Hispanics should be considered separately from other ethnicity groups.Originality value - A markedly higher rate of potentially inappropriate drug use in the elderly Medicaid population exists following the Fick update. These findings provide evidence that the potential use of inappropriate drugs in Hispanics should be considered separately from other ethnicity groups. By comparing drug use based on therapeutic category, genitourinary products were found to have the highest potential for inappropriate prescribing.