Medicare Drug Benefit

Cost sharing provisions in the Medicare drug benefit could continue the tendency of noncompliance with prescription drug regimens among Medicare beneficiaries, particularly among nonelderly beneficiaries with disabilities, a study in the Archives of Internal Medicine found.

Researchers collaborated with CMS to measure the extent to which Medicare beneficiaries:

Did not fill a prescription because of cost;
Skipped doses to extend a medication supply; and
Took smaller doses than prescribed to make medicine supply last longer.

Data was based on responses to the Medicare Current Beneficiary Survey conducted in fall 2004, about one year before implementation of the drug benefit.

Among nonelderly Medicare beneficiaries with disabilities, the study found that 29.4% reported cost related nonadherence and 70.7% reported using cost-reducing strategies. By comparison, 12.6% of elderly Medicare beneficiaries reported cost-related nonadherence and 72.7% reported using cost-reducing strategies, according to the authors.

The researchers recommended that policymakers within the first few years of the drug benefit closely examine what effect it has on medication noncompliance, noting that dual eligibles -- those eligible for both Medicare and Medicaid -- might be at greater risk of noncompliance because prescription drug plans include more formulary restrictions and greater cost sharing than Medicaid drug coverage (Soumerai et al., Archives of Internal Medicine, 9/25). This is part of the California Healthline Daily Edition, a summary of health policy coverage from major news organizations. Sign up for an email subscription.