The Impact of the Medicare Part D Prescription Benefit on Generic Drug Use
Background Little information exists regarding the impact of Medicare Part D on generic drug use. Objective To examine changes in the use of generic prescriptions attributable to Part D among a sample of Medicare beneficiaries. Design, participants, and measurements Difference-in-difference analysis...
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| Published in | Journal of general internal medicine : JGIM Vol. 23; no. 10; pp. 1673 - 1678 |
|---|---|
| Main Authors | , , , |
| Format | Journal Article |
| Language | English |
| Published |
New York
Springer-Verlag
01.10.2008
Springer Springer Nature B.V |
| Subjects | |
| Online Access | Get full text |
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| Abstract | Background
Little information exists regarding the impact of Medicare Part D on generic drug use.
Objective
To examine changes in the use of generic prescriptions attributable to Part D among a sample of Medicare beneficiaries.
Design, participants, and measurements
Difference-in-difference analysis of pharmacy claims of Part D enrollees and non-enrollees aged 67–79 years from 2005 to 2006. The final sample represented approximately 2.4 million unique subjects. Analyses were conducted separately for major therapeutic classes, limited to subjects filling at least one prescription within the class during 2005 and 2006, and adjusted for subject characteristics, prescription characteristics, socio-demographic characteristics measured through zipcode-linked Census data, baseline differences between Part D and non-Part D enrollees, and secular trends in generic use.
Results
Generic drugs accounted for 58% of total prescriptions. Among the entire group of beneficiaries, there was a trend of increased generic drug use in 13 out of 15 drug classes examined. However, after adjusting for potential confounders, the growth rate of generic drug use was lower among Part D enrollees than among non-enrollees; enrollees were slightly less likely to fill prescriptions for generic drugs vs. brand-name drugs in 2006 compared to 2005 (odds ratio 0.95, 95% confidence interval 0.94–0.95).
Conclusions
Despite secular trends of increased utilization of generic drugs among both Part D enrollees and non-enrollees, the net impact of Part D among these beneficiaries was a modest decrease in the use of generic drugs. This finding, which is consistent with economic theory but contrary to several recent reports, highlights the complexity of assessing the impact of Part D on overall consumer welfare. |
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| AbstractList | Little information exists regarding the impact of Medicare Part D on generic drug use.
To examine changes in the use of generic prescriptions attributable to Part D among a sample of Medicare beneficiaries.
Difference-in-difference analysis of pharmacy claims of Part D enrollees and non-enrollees aged 67-79 years from 2005 to 2006. The final sample represented approximately 2.4 million unique subjects. Analyses were conducted separately for major therapeutic classes, limited to subjects filling at least one prescription within the class during 2005 and 2006, and adjusted for subject characteristics, prescription characteristics, socio-demographic characteristics measured through zipcode-linked Census data, baseline differences between Part D and non-Part D enrollees, and secular trends in generic use.
Generic drugs accounted for 58% of total prescriptions. Among the entire group of beneficiaries, there was a trend of increased generic drug use in 13 out of 15 drug classes examined. However, after adjusting for potential confounders, the growth rate of generic drug use was lower among Part D enrollees than among non-enrollees; enrollees were slightly less likely to fill prescriptions for generic drugs vs. brand-name drugs in 2006 compared to 2005 (odds ratio 0.95, 95% confidence interval 0.94-0.95).
Despite secular trends of increased utilization of generic drugs among both Part D enrollees and non-enrollees, the net impact of Part D among these beneficiaries was a modest decrease in the use of generic drugs. This finding, which is consistent with economic theory but contrary to several recent reports, highlights the complexity of assessing the impact of Part D on overall consumer welfare. Background Little information exists regarding the impact of Medicare Part D on generic drug use. Objective To examine changes in the use of generic prescriptions attributable to Part D among a sample of Medicare beneficiaries. Design, participants, and measurements Difference-in-difference analysis of pharmacy claims of Part D enrollees and non-enrollees aged 67–79 years from 2005 to 2006. The final sample represented approximately 2.4 million unique subjects. Analyses were conducted separately for major therapeutic classes, limited to subjects filling at least one prescription within the class during 2005 and 2006, and adjusted for subject characteristics, prescription characteristics, socio-demographic characteristics measured through zipcode-linked Census data, baseline differences between Part D and non-Part D enrollees, and secular trends in generic use. Results Generic drugs accounted for 58% of total prescriptions. Among the entire group of beneficiaries, there was a trend of increased generic drug use in 13 out of 15 drug classes examined. However, after adjusting for potential confounders, the growth rate of generic drug use was lower among Part D enrollees than among non-enrollees; enrollees were slightly less likely to fill prescriptions for generic drugs vs. brand-name drugs in 2006 compared to 2005 (odds ratio 0.95, 95% confidence interval 0.94–0.95). Conclusions Despite secular trends of increased utilization of generic drugs among both Part D enrollees and non-enrollees, the net impact of Part D among these beneficiaries was a modest decrease in the use of generic drugs. This finding, which is consistent with economic theory but contrary to several recent reports, highlights the complexity of assessing the impact of Part D on overall consumer welfare. Little information exists regarding the impact of Medicare Part D on generic drug use. To examine changes in the use of generic prescriptions attributable to Part D among a sample of Medicare beneficiaries. Difference-in-difference analysis of pharmacy claims of Part D enrollees and non-enrollees aged 67-79 years from 2005 to 2006. The final sample represented approximately 2.4 million unique subjects. Analyses were conducted separately for major therapeutic classes, limited to subjects filling at least one prescription within the class during 2005 and 2006, and adjusted for subject characteristics, prescription characteristics, socio-demographic characteristics measured through zipcode-linked Census data, baseline differences between Part D and non-Part D enrollees, and secular trends in generic use. Generic drugs accounted for 58% of total prescriptions. Among the entire group of beneficiaries, there was a trend of increased generic drug use in 13 out of 15 drug classes examined. However, after adjusting for potential confounders, the growth rate of generic drug use was lower among Part D enrollees than among non-enrollees; enrollees were slightly less likely to fill prescriptions for generic drugs vs. brand-name drugs in 2006 compared to 2005 (odds ratio 0.95, 95% confidence interval 0.94-0.95). Despite secular trends of increased utilization of generic drugs among both Part D enrollees and non-enrollees, the net impact of Part D among these beneficiaries was a modest decrease in the use of generic drugs. This finding, which is consistent with economic theory but contrary to several recent reports, highlights the complexity of assessing the impact of Part D on overall consumer welfare.[PUBLICATION ABSTRACT] Little information exists regarding the impact of Medicare Part D on generic drug use.BACKGROUNDLittle information exists regarding the impact of Medicare Part D on generic drug use.To examine changes in the use of generic prescriptions attributable to Part D among a sample of Medicare beneficiaries.OBJECTIVETo examine changes in the use of generic prescriptions attributable to Part D among a sample of Medicare beneficiaries.Difference-in-difference analysis of pharmacy claims of Part D enrollees and non-enrollees aged 67-79 years from 2005 to 2006. The final sample represented approximately 2.4 million unique subjects. Analyses were conducted separately for major therapeutic classes, limited to subjects filling at least one prescription within the class during 2005 and 2006, and adjusted for subject characteristics, prescription characteristics, socio-demographic characteristics measured through zipcode-linked Census data, baseline differences between Part D and non-Part D enrollees, and secular trends in generic use.DESIGN, PARTICIPANTS, AND MEASUREMENTSDifference-in-difference analysis of pharmacy claims of Part D enrollees and non-enrollees aged 67-79 years from 2005 to 2006. The final sample represented approximately 2.4 million unique subjects. Analyses were conducted separately for major therapeutic classes, limited to subjects filling at least one prescription within the class during 2005 and 2006, and adjusted for subject characteristics, prescription characteristics, socio-demographic characteristics measured through zipcode-linked Census data, baseline differences between Part D and non-Part D enrollees, and secular trends in generic use.Generic drugs accounted for 58% of total prescriptions. Among the entire group of beneficiaries, there was a trend of increased generic drug use in 13 out of 15 drug classes examined. However, after adjusting for potential confounders, the growth rate of generic drug use was lower among Part D enrollees than among non-enrollees; enrollees were slightly less likely to fill prescriptions for generic drugs vs. brand-name drugs in 2006 compared to 2005 (odds ratio 0.95, 95% confidence interval 0.94-0.95).RESULTSGeneric drugs accounted for 58% of total prescriptions. Among the entire group of beneficiaries, there was a trend of increased generic drug use in 13 out of 15 drug classes examined. However, after adjusting for potential confounders, the growth rate of generic drug use was lower among Part D enrollees than among non-enrollees; enrollees were slightly less likely to fill prescriptions for generic drugs vs. brand-name drugs in 2006 compared to 2005 (odds ratio 0.95, 95% confidence interval 0.94-0.95).Despite secular trends of increased utilization of generic drugs among both Part D enrollees and non-enrollees, the net impact of Part D among these beneficiaries was a modest decrease in the use of generic drugs. This finding, which is consistent with economic theory but contrary to several recent reports, highlights the complexity of assessing the impact of Part D on overall consumer welfare.CONCLUSIONSDespite secular trends of increased utilization of generic drugs among both Part D enrollees and non-enrollees, the net impact of Part D among these beneficiaries was a modest decrease in the use of generic drugs. This finding, which is consistent with economic theory but contrary to several recent reports, highlights the complexity of assessing the impact of Part D on overall consumer welfare. |
| Author | Zhang, James X. Yin, Wesley Alexander, G. Caleb Sun, Shawn X. |
| Author_xml | – sequence: 1 givenname: James X. surname: Zhang fullname: Zhang, James X. organization: Department of Pharmacy, School of Pharmacy, Virginia Commonwealth University – sequence: 2 givenname: Wesley surname: Yin fullname: Yin, Wesley organization: Center for Health and Social Sciences, University of Chicago, Harvard University, Robert Wood Johnson Scholars Program in Health Policy, University of Chicago, Harris School of Public Policy – sequence: 3 givenname: Shawn X. surname: Sun fullname: Sun, Shawn X. organization: Health Outcomes Department, Walgreens Health Services – sequence: 4 givenname: G. Caleb surname: Alexander fullname: Alexander, G. Caleb email: galexand@uchicago.edu organization: Center for Health and Social Sciences, University of Chicago, Section of General Internal Medicine, Department of Medicine, University of Chicago, MacLean Center for Clinical Medical Ethics, University of Chicago, Department of Pharmacy Practice, University of Illinois at Chicago School of Pharmacy |
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| Snippet | Background
Little information exists regarding the impact of Medicare Part D on generic drug use.
Objective
To examine changes in the use of generic... Little information exists regarding the impact of Medicare Part D on generic drug use. To examine changes in the use of generic prescriptions attributable to... Little information exists regarding the impact of Medicare Part D on generic drug use. To examine changes in the use of generic prescriptions attributable to... Little information exists regarding the impact of Medicare Part D on generic drug use.BACKGROUNDLittle information exists regarding the impact of Medicare Part... |
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| SubjectTerms | Aged Biological and medical sciences Drug Prescriptions - economics Drug Utilization Review - methods Drug Utilization Review - trends Drugs, Generic - economics Drugs, Generic - therapeutic use Female General aspects Generic drugs Humans Impact analysis Insurance, Pharmaceutical Services - economics Insurance, Pharmaceutical Services - trends Internal Medicine Male Medical sciences Medicare Medicare Part D - economics Medicare Part D - trends Medicine Medicine & Public Health Miscellaneous Original Original Article Prescription drug plans Public health. Hygiene Public health. Hygiene-occupational medicine Random Allocation United States |
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| Title | The Impact of the Medicare Part D Prescription Benefit on Generic Drug Use |
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