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


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.





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Publication Info

Eapen, Zubin J, Bradley G Hammill, Soko Setoguchi, Kevin A Schulman, Eric D Peterson, Adrian F Hernandez and Lesley H Curtis (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). p. e000242. 10.1161/JAHA.113.000242 Retrieved from https://hdl.handle.net/10161/15016.

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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 education.


Bradley Gordon Hammill

Associate Professor in Population Health Sciences

Brad Hammill, DrPH, is an Associate Professor in the Department of Population Health Sciences within the School of Medicine and a member of the Duke Clinical Research Institute. Dr. Hammill received his DrPH in Biostatistics from The University of North Carolina at Chapel Hill. His research is focused on leveraging real-world data—including electronic health record data, health insurance claims data, and registry data—for clinical research.

Areas of expertise: Biostatistics, Real-World Data, Health Services Research, Health Policy, and Epidemiology


Lesley H. Curtis

Professor in Population Health Sciences

Lesley H. Curtis is Professor in the Departments of Population Health Sciences and Medicine in the Duke School of Medicine and was inaugural chair of the Department of Population Health Sciences.  A health services researcher by training, Dr. Curtis is an expert in the use of health care and Medicare claims data for health services and clinical outcomes research, and a leader in national data quality efforts. Dr. Curtis has led the linkage of Medicare claims with several large clinical registries and epidemiological cohort studies including the Framingham Heart Study and the Cardiovascular Health Study. Dr. Curtis currently serves as a senior policy advisor at the Food and Drug Administration supporting the Agency’s evidence generation initiative, and is co-PI of the NIH Pragmatic Trials Collaboratory, an NIH initiative to strengthen the national capacity for large-scale research studies embedded in health care delivery.

Areas of expertise: Health Services Research and Health Policy


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