On January 1, 2006 the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 (known as Medicare Part D) added prescription drug coverage to Medicare. The cost of such medications is subsidized in large part by the government, and the Affordable Care Act seeks to remove the hated “donut hole” obligation under Part D. But has such drug coverage improved the health care outcomes of older beneficiaries? Researchers at the University of Illinois and the Johns Hopkins University have made the broadest test yet of Medicare Part D prescription drug program’s promise — that covering drugs would keep seniors out of the hospital.
Comparing national records from before and after 2006, when Part D kicked in, they found that drug coverage was associated with an 8 percent drop in hospital admissions and nearly as much in hospital-cost savings — an amount they calculate to be $1.5 billion a year. For some conditions, the fall in admissions that came with Part D coverage was striking: down 20 percent for dehydration; down 32 percent for chronic obstructive pulmonary disease; down 18 percent for congestive heart failure; and down 13 percent for coronary atherosclerosis. Previous research has also shown that better drug coverage is associated with lower hospital admissions. But the samples were smaller. Or the studies looked at changes in existing drug plans, not the difference between no coverage and full coverage, according to co-author Robert Kaestner, an economist at the University of Illinois at Chicago.
What they didn’t find: any difference in death rates between the seniors who had access to drugs under Part D and those who didn’t. They thought broader drug coverage might reduce mortality. “It’s somewhat surprising that we didn’t see a mortality effect, given that we did see decreases in hospitalization,” Kaestner said in an interview. But the researchers looked only at deaths at the time. Perhaps drug coverage has a cumulative effect that wouldn’t show up in mortality statistics until later, he said.
Read more: Kaiser Health News
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