Effect of Medicare Part D on Ethnoracial Disparities in Antidementia Medication Use. Issue 9 (10th August 2018)

• Record Type: Journal Article
• Authors: Lind, Kimberly E.; Hildreth, Kerry; Lindrooth, Richard; Morrato, Elaine; Crane, Lori A.; Perraillon, Marcelo Coca
• Is Part Of: Journal of the American Geriatrics Society. Volume 66:Issue 9(2018)
• Page Start: 1760
• Page End: 1767
• Publication Date: 2018-08-10
• Subjects: dementia -- Medicare Part D -- disparities -- cholinesterase inhibitor -- antidementia medication; Geriatrics -- Periodicals; 618.97
• DOI: 10.1111/jgs.15494
• Languages: English
• ISSNs: 0002-8614

Abstract

Abstract : Objectives: To examine ethnoracial disparities in antidementia medication use, accounting for implementation of Part D, and to evaluate the role of prescription drug coverage as a cause of antidementia medication disparities. Design: Rotating panel of Medicare beneficiaries who participated in the Medicare Current Beneficiary Survey from 2003 to 2013. Setting: Nationally representative sample of Medicare fee‐for‐service (FFS) beneficiaries with dementia. Participants: Community‐dwelling FFS Medicare beneficiaries with dementia (N=4, 304). Measurements: Antidementia medication use, defined as at least one prescription fill in a given year. Results: Unadjusted antidementia medication use was 10–percentage points lower for ethnoracial minority beneficiaries before Part D was implemented in 2006 (p=.01). This difference was attenuated after adjusting for demographic and socioeconomic factors (6–percentage points; p=.10). Part D was associated with a 6–percentage point increase in use (p<.01). The increase in use associated with Part D was higher although not statistically significantly so in ethnoracial minority beneficiaries (8–percentage points, p=.08). Analyses of each ethnoracial group found a significant effect of Part D only in Hispanic/Latino beneficiaries (18–percentage points; p<.01, adjusted). Conclusion: Antidementia medication disparities were reduced with expanded prescription drug coverage through Medicare Part D. Increases in antidementia medication use for minority beneficiaries started after Part D was implemented, with the largest increases in use observed in Hispanic/Latino beneficiaries.