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Who enrolls in the Medicare Part D prescription drug benefit program? Medication use among patients with heart failure.

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Date
2013-09-11
Authors
Eapen, Zubin J
Hammill, Bradley G
Setoguchi, Soko
Schulman, Kevin A
Peterson, Eric D
Hernandez, Adrian F
Curtis, Lesley H
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Abstract
BACKGROUND: Dispensing data from Medicare Part D standalone prescription drug plans are now available, but characteristics of enrollees with heart failure have not been well described. METHODS AND RESULTS: We identified 81 874 patients with prevalent heart failure as of January 1, 2010, in a nationally representative 5% sample of Medicare beneficiaries. We classified patients according to enrollment in a Medicare Part D plan as of January 1, 2010. Demographic characteristics, comorbid conditions, and prescriptions were compared by enrollment status. A total of 49 252 (60.2%) were enrolled in a Medicare Part D plan as of January 1. Enrollees were more often women, black, and of lower socioeconomic status. Enrollees with heart failure more often filled prescriptions for loop diuretics than angiotensin-converting enzyme inhibitors or angiotensin receptor blockers, β-blockers, or aldosterone antagonists. During the first 4 months of 2010, 5444 (12.3%) reached the coverage gap, and 566 (1.3%) required catastrophic coverage beyond the gap. CONCLUSIONS: Medicare beneficiaries with heart failure differ significantly according to enrollment in Part D prescription drug plans and represent a population underrepresented in clinical efficacy trials. Many face the coverage gap, and few select Medicare Part D plans that provide coverage during the gap. Linking Medicare Part D event data with clinical registries could help to determine whether eligible enrollees are undertreated for heart failure.
Type
Journal article
Subject
Medicare Part D
heart failure
outcome assessment (health care)
Aged, 80 and over
Drug Utilization
Female
Heart Failure
Humans
Male
Medicare Part D
Prescription Drugs
United States
Permalink
https://hdl.handle.net/10161/15016
Published Version (Please cite this version)
10.1161/JAHA.113.000242
Publication Info
Eapen, Zubin J; Hammill, Bradley G; Setoguchi, Soko; Schulman, Kevin A; Peterson, Eric D; Hernandez, Adrian F; & Curtis, Lesley H (2013). Who enrolls in the Medicare Part D prescription drug benefit program? Medication use among patients with heart failure. J Am Heart Assoc, 2(5). pp. e000242. 10.1161/JAHA.113.000242. Retrieved from https://hdl.handle.net/10161/15016.
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Scholars@Duke

Curtis

Lesley H. Curtis

Professor in Population Health Sciences
Lesley H. Curtis is Professor and Chair of the Department of Population Health Sciences in the Duke School of Medicine.  A health services researcher by training, Dr. Curtis is an expert in the use of Medicare claims data for health services and clinical outcomes research, and a leader in national data quality efforts. Dr. Curtis serves as co-PI of the FDA’s Sentinel Innovation Center, Co-Investigator of the Data Core for the FDA’s Sentinel Initiative to monitor the safety of
Eapen

Zubin John Eapen

Adjunct Associate Professor in the Department of Medicine
As director of the Duke Heart Failure Same-Day Access Clinic, I am dedicated to improving outcomes for patients with heart failure. This clinic allows patients to see a health care provider quickly, and receive treatments for relief of symptoms. I strive to help patients with heart failure avoid the emergency department and hospital when possible, and live better at home.As director of education IT innovations in the Department of Medicine, I lead efforts in continuing medical educat
Hammill

Bradley Gordon Hammill

Associate Professor in Population Health Sciences
Areas of expertise: Biostatistics, Real-World Data, Health Services Research, Health Policy, and Epidemiology
Hernandez

Adrian Felipe Hernandez

Duke Health Cardiology Professor
Peterson

Eric David Peterson

Fred Cobb, M.D. Distinguished Professor of Medicine
Dr Peterson is the Fred Cobb Distinguished Professor of Medicine in the Division of Cardiology, a DukeMed Scholar, and the Past Executive Director of the Duke Clinical Research Institute (DCRI), Durham, NC, USA. Dr Peterson is the Principal Investigator of the National Institute of Health, Lung and Blood Institute (NHLBI) Spironolactone Initiation Registry Randomized Interventional Trial in Heart Failure With Preserved Ejection Fraction (SPIRRIT) Trial  He is also the Principal I
This author no longer has a Scholars@Duke profile, so the information shown here reflects their Duke status at the time this item was deposited.
Schulman

Kevin Alan Schulman

Adjunct Professor in the Department of Medicine
Kevin A. Schulman, MD, MBA, is a professor of medicine and the Gregory Mario and Jeremy Mario Professor of Business Administration (2010 - 2016) at Duke University. He is a visiting professor of business administration at Harvard Business School. He holds several leadership appointments at Duke. He is an associate director of the Duke Clinical Research Institute in the School of Medicine, the country's largest academic clinical research organization. In Duke's Fuqua School of Business, he s
This author no longer has a Scholars@Duke profile, so the information shown here reflects their Duke status at the time this item was deposited.
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