Book Description

The Medicare Part D program enhanced Medicare beneficiaries ability to afford prescription drugs through reduced drug prices, thereby increasing their drug utilization rates. Considering potentially high price responsiveness of lower degree of necessity drugs, Part D is likely to induce higher consumption of improperly used prescription drugs, including inappropriate and off-label drugs, in Medicare enrollees. Yet little evidence exists about howand to what extentPart D might have an impact on these types of medication use of elderly Medicare recipients. This thesis using multi-year (2001-2010) data from the Medical Expenditure Panel Survey (MEPS) explores whether and how much Part D has influenced inappropriate and off-label drug use patterns among elderly Medicare beneficiaries. The difference-in-differences (DD) model was used for both analyses. The inappropriate drug use study found that Part D did not promote the use of Beers Criteria (BC) drugs among elderly Medicare beneficiaries; rather, there has been a decreasing trend in the use of BC drugs over time regardless of type of insurance coverage. Similarly, Part D did not promote off-label psychotherapeutic drug use among those who had newly obtained drug coverage through Part D. However, dual-eligibles increased off-label psychotherapeutic drug use after Part D went into effect, indicating that the transition of prescription drug costs from Medicaid to Medicare after Part D might have influenced the off-label psychotherapeutic drug use patterns of dual-eligibles. Both inappropriate and off-label drug use rates are remarkably high among elderly Medicare beneficiaries, suggesting that continuing clinical and policy efforts should be established to reduce non-proper use of prescription drugs among elderly Medicare enrollees in order to improve quality prescription drug therapies.