Who enrolls in the Medicare Part D prescription drug benefit program? Medication use among patients with heart failure.
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 articleSubject
Medicare Part Dheart failure
outcome assessment (health care)
Aged, 80 and over
Drug Utilization
Female
Heart Failure
Humans
Male
Medicare Part D
Prescription Drugs
United States
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https://hdl.handle.net/10161/15016Published Version (Please cite this version)
10.1161/JAHA.113.000242Publication 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.This is constructed from limited available data and may be imprecise. To cite this
article, please review & use the official citation provided by the journal.
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Show full item recordScholars@Duke
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
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
Bradley Gordon Hammill
Associate Professor in Population Health Sciences
Areas of expertise: Biostatistics, Real-World Data, Health Services Research, Health
Policy, and Epidemiology
Adrian Felipe Hernandez
Duke Health Cardiology Professor
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.
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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