This Program Project proposes a fundamental examination of the economic underpinnings of Medicare Part D and its consequences. Part D represents one of the most important reforms to the US Medicare system in its history, and a policy experiment with weighty consequences. We have assembled a team of researchers from several institutions with decades of experience studying the economics of consumer choice, the economics of aging, insurance design, pharmaceutical innovation, and health policy. Centered at RAND, administrative and data cores will promote close collaboration across the research teams, as well as links with CMS, NIA, and the external research community. The data core brings to bear a unique and lengthy list of datasets that permit study of many economic aspects of Part D, and provide opportunities for cross-validation of results. The five projects study Part D from an array of perspectives: beneficiaries;insurers;drug manufacturers;policy;and elderly households. The research projects complement each other in valuable ways, and they are supported by two Cores designed to ensure synergistic effort. Questions about demand for drugs, plan choice, and benefit design will be addressed through both reduced-form and structural analysis, and with a variety of administrative and survey data sets. Basic questions such as whether consumers behave rationally, and the value of Part D, will be addressed. The Administrative Core will support this effort by bringing together a Steering Committee of all project teams and convening annual summer workshops. It will also host two research conferences on Part D. In addition, a pilot program will develop innovative cross-cutting research. The administrative core will also support the development of Part D research in the external research community through visiting scholars, two annual research conferences, public use data files, and postdoctoral positions. In sum, this program project will provide an integrated economic evaluation of the welfare effects of Part D, and promote Medicare-related research of policy and scientific interest.

Public Health Relevance

Medicare Part D represents a large social experiment, and there is much we can learn from both a scientific and policy perspective. This POI will provide a comprehensive examination of the economic underpinnings of Medicare Part D and its welfare consequences using an array of methods and data sets.

Agency
National Institute of Health (NIH)
Institute
National Institute on Aging (NIA)
Type
Research Program Projects (P01)
Project #
5P01AG033559-04
Application #
8721809
Study Section
Special Emphasis Panel (ZAG1)
Program Officer
Phillips, John
Project Start
2011-09-15
Project End
2016-06-30
Budget Start
2014-09-01
Budget End
2015-06-30
Support Year
4
Fiscal Year
2014
Total Cost
Indirect Cost
Name
University of Southern California
Department
Type
Other Specialized Schools
DUNS #
City
Los Angeles
State
CA
Country
United States
Zip Code
90089
Van Nuys, Karen; Joyce, Geoffrey; Ribero, Rocio et al. (2018) Frequency and Magnitude of Co-payments Exceeding Prescription Drug Costs. JAMA 319:1045-1047
Song, Yan; Barthold, Douglas (2018) The effects of state-level pharmacist regulations on generic substitution of prescription drugs. Health Econ 27:1717-1737
Trish, Erin; Xu, Jianhui; Joyce, Geoffrey (2018) Growing Number Of Unsubsidized Part D Beneficiaries With Catastrophic Spending Suggests Need For An Out-Of-Pocket Cap. Health Aff (Millwood) 37:1048-1056
Chen, Alice J; Goldman, Dana P (2018) Productivity Benefits of Medical Care: Evidence from US-Based Randomized Clinical Trials. Value Health 21:905-910
Blumenthal, Daniel M; Goldman, Dana P; Jena, Anupam B (2017) Outcomes-Based Pricing as a Tool to Ensure Access to Novel but Expensive Biopharmaceuticals. Ann Intern Med 166:219-220
Trish, Erin; Xu, Jianhui; Joyce, Geoffrey (2016) Medicare Beneficiaries Face Growing Out-Of-Pocket Burden For Specialty Drugs While In Catastrophic Coverage Phase. Health Aff (Millwood) 35:1564-71
Jena, Anupam B; Goldman, Dana; Karaca-Mandic, Pinar (2016) Hospital Prescribing of Opioids to Medicare Beneficiaries. JAMA Intern Med 176:990-7
Lakdawalla, Darius; Yin, Wesley (2015) Insurers' Negotiating Leverage and the External Effects of Medicare Part D. Rev Econ Stat 97:314-331
Jena, Anupam B; Goldman, Dana P; Seabury, Seth A (2015) Incidence of sexually transmitted infections after human papillomavirus vaccination among adolescent females. JAMA Intern Med 175:617-23
Gaudette, Étienne; Goldman, Dana P; Messali, Andrew et al. (2015) Do Statins Reduce the Health and Health Care Costs of Obesity? Pharmacoeconomics 33:723-34

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