In 2006, the United States implemented the Medicare Modernization Act, which expanded prescription drug coverage for Medicare beneficiaries at an estimated cost of $768 billion dollars over the next decade. Improved access to drug benefits may improve cardiovascular outcomes for the elderly by providing financial access to effective therapy. However, there is limited research about the impact of prescription drug coverage on health outcomes. In addition, although black enrollees have been found to have markedly lower use of antihypertensive, lipid-lowering and anti-platelet medications, little is known about the role of prescription drug coverage as a mediator of racial and socioeconomic disparities in cardiovascular outcomes. In this project, we will investigate the effect of prescription drug benefits on the use of appropriate secondary preventive medication and achievement of favorable clinical outcomes among Medicare managed care enrollees with cardiovascular disease. The project will also assess the role of prescription drug coverage in explaining racial and socioeconomic disparities in cardiovascular outcomes.
Effective drugs, such as aspirin, beta-blockers, statins, and ace-inhibitors, are a cornerstone in the prevention and treatment of heart disease, yet over half of appropriate patients do not receive them. The cost of chronic drug therapy is a substantial barrier for elderly patients who have lower fixed incomes and sizable out-of- pocket spending on health care. This study will assess the effect of prescription drug coverage on outcomes of care for elderly patients with coronary heart disease.
|Cooper, Alicia L; Dore, David D; Kazis, Lewis E et al. (2014) Predictors of high-risk prescribing among elderly Medicare Advantage beneficiaries. Am J Manag Care 20:e469-78|
|Qato, Danya M; Trivedi, Amal N (2013) Receipt of high risk medications among elderly enrollees in Medicare Advantage plans. J Gen Intern Med 28:546-53|
|Cooper, Alicia L; Kazis, Lewis E; Dore, David D et al. (2013) Underreporting high-risk prescribing among Medicare Advantage plans: a cross-sectional analysis. Ann Intern Med 159:456-62|
|Cooper, Alicia L; Trivedi, Amal N (2012) Fitness memberships and favorable selection in Medicare Advantage plans. N Engl J Med 366:150-7|
|Trivedi, Amal N; Grebla, Regina C; Jiang, Lan et al. (2012) Duplicate federal payments for dual enrollees in Medicare Advantage plans and the Veterans Affairs health care system. JAMA 308:67-72|