Thesis
Discrepancies in total and out-of-pocket prescription costs between working-age and elderly Medicare beneficiaries
Washington State University
Master of Health Policy and Administration (MHPA), Washington State University
2009
Handle:
https://hdl.handle.net/2376/102009
Abstract
Objective. To analyze differences in total and out-of-pocket prescription drug costs and use between working-age and elderly Medicare beneficiaries and to determine the key factors associated with prescription costs and utilizations levels among Medicare recipients. Methods. This secondary data analysis uses a national sample of more than 11,000 respondents to the 2005 Medicare Current Beneficiary Survey. Categorical analyses of total prescription costs, based on the Medicare Part D standard benefit, help highlight potential differences in coverage. Multivariate regression analyses examine how demographic, insurance, and health factors influence total and out-of-pocket prescription costs and rates of prescription medication utilization. Results. Working-age beneficiaries report average total prescription costs of $3,206 vs. $2,048 for elderly beneficiaries, along with higher prescription utilization levels (43.27 annual prescribed medicine events vs. 30.51). Projecting total prescription costs onto the 2006 Medicare Part D standard benefit, nearly 47% of working-age beneficiaries report total costs that exceed the lower threshold for the "doughnut hole" of $2,250, compared the less than 34% of the elderly. Furthermore, more than 21% of the disabled beneficiaries have total prescription drug costs in excess of the $5,100 catastrophic coverage level, versus less than 9% of beneficiaries aged 65 or older. After controlling for gender, race, ethnicity, income, and insurance type, working-age beneficiaries still report nearly six additional prescribed medicine events (PMEs) per year. When controlling for these factors, age is not a significant variable when determining total and out-of-pocket costs per prescription. Factors with strong associations with cost per PME include income level, insurance type, and race. Conclusions. In the year preceding Medicare Part D implementation, working age beneficiaries report greater total prescription cost levels, due in large part to increased prescription drug utilization. Given the health and demographic differences between working-age and elderly beneficiaries, along with the impact of prescription drug insurance type on cost and use, it is important to monitor changes in prescription cost and utilization following the implementation of Medicare Part D.
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Details
- Title
- Discrepancies in total and out-of-pocket prescription costs between working-age and elderly Medicare beneficiaries
- Creators
- Joshua James Engle
- Contributors
- Jae Kennedy (Degree Supervisor)
- Awarding Institution
- Washington State University
- Academic Unit
- Health Policy and Administration, Department of
- Theses and Dissertations
- Master of Health Policy and Administration (MHPA), Washington State University
- Publisher
- Washington State University; Pullman, Wash. :
- Identifiers
- 99900525133701842
- Language
- English
- Resource Type
- Thesis