Article
Health Care Sciences & Services
Huseyin Naci, Ilias Kyriopoulos, William B. Feldman, Thomas J. Hwang, Aaron S. Kesselheim, Amitabh Chandra
Summary: Newly approved drugs are often subject to formulary exclusions and restrictions in Medicare Part D. Ensuring that formulary design is closely linked to the therapeutic value of drugs would improve patients' welfare.
Article
Economics
Abby Alpert, Darius Lakdawalla, Neeraj Sood
Summary: This study investigates the impact of direct-to-consumer advertising (DTCA) for prescription drugs on drug utilization. It utilizes a large shock to DTCA caused by the introduction of Medicare Part D as an exogenous variable. The results show that exposure to advertising leads to significant increases in treatment initiation and medication adherence, and also has positive spillover effects on non-advertised generic drugs.
JOURNAL OF PUBLIC ECONOMICS
(2023)
Editorial Material
Medicine, General & Internal
Khrysta Baig, Stacie B. Dusetzina, David D. Kim, Ashley A. Leech
Summary: Medicare may soon have to cover antiobesity medications, leading to a greater need to address effectiveness and cost concerns among its beneficiaries.
NEW ENGLAND JOURNAL OF MEDICINE
(2023)
Article
Economics
Judith Liu, Yuting Zhang, Cameron M. Kaplan
Summary: The Affordable Care Act aims to eliminate the Medicare prescription drug coverage gap and reduce medication costs. This study evaluates the impact of filling the gap on individuals' out-of-pocket spending and medication use. The findings show that filling the gap substantially reduces out-of-pocket spending and increases the use of branded drugs, particularly for older beneficiaries or those with comorbidities.
Article
Medicine, General & Internal
Mariana P. Socal, Ge Bai, Gerard F. Anderson
Summary: A study using Medicare Part D data found that prescribers and patients requested branded products for 30.4% of multisource drugs, leading to an additional annual cost of $1.67 billion to the Medicare program and $270 million to patients. Measures should be considered to discourage prescribers and patients from requesting branded products to reduce costs.
Article
Health Care Sciences & Services
Judith Liu, Yuting Zhang, Cameron M. Kaplan
Summary: This study examines the impact of changes in insurance benefit design on medication use of older adults with mental disorders using US Medicare claims data. The findings suggest that closing the Medicare prescription drug coverage gap substantially reduces out-of-pocket spending, particularly for those with severe mental disorders. The policy also leads to an increase in branded drug utilization for the Medicare population, beneficiaries with severe mental disorders, and common mental disorders, while the effect is smaller for beneficiaries with Alzheimer's disease and dementia. However, the policy decreases the use of generic drugs for all groups. The results highlight the differential impacts of medication cost reduction on different diseases and emphasize the need for tailored interventions for severe mental health disorders.
Article
Economics
Colleen Carey, Ethan M. J. Lieber, Sarah Miller
Summary: In the practice of drug firms making payments to physicians to promote prescription drugs, physicians increase prescribing of drugs they receive payments for shortly after receipt, with no differential trends seen between paid and unpaid physicians prior to the payment. When major drugs go off patent, physicians who receive payments transition their patients to generics as quickly as those who do not. Drug quality is largely unaffected by receipt of payments, as shown by efficacy data in three major therapeutic classes.
JOURNAL OF PUBLIC ECONOMICS
(2021)
Article
Health Care Sciences & Services
Joohyun Park, Kevin A. Look
Summary: The study found that the Affordable Care Act's Medicare Part D coverage gap reform has helped reduce out-of-pocket drug costs for beneficiaries, but did not have a noticeable impact on drug use or total drug spending.
HEALTH SERVICES RESEARCH
(2022)
Article
Medicine, General & Internal
Minghui Li, Jing Yuan, Chelsea Dezfuli, Z. Kevin Lu
Summary: The Medicare Part D coverage expansion led to a short-term increase in the utilization of benzodiazepines among older adults, followed by a decreasing trend in the long term. Meanwhile, the alternative therapy showed a decreasing trend in utilization following the coverage expansion.
Article
Health Care Sciences & Services
Inmaculada Hernandez, Davene R. Wright, Jingchuan Guo, William H. Shrank
Summary: The reconsideration of excluding weight loss drugs from Medicare Part D coverage is based on the proven effectiveness and safety profile of drugs activating the GLP-1R pathway in reducing weight and improving metabolism.
JOURNAL OF GENERAL INTERNAL MEDICINE
(2023)
Article
Health Care Sciences & Services
Benjamin Wormser, Mariana P. Socal, Gerard Anderson
Summary: This study compared the coverage of guideline-recommended COPD inhalers between S-PDPs and MA-PD plans. The results showed that S-PDPs were more likely to require coinsurance for inhalers across all therapeutic categories, whereas MA-PD plans required prior authorization more frequently for 3 of the 6 therapeutic categories. This has implications for the management of outpatient COPD and should be considered by providers and policy makers.
AMERICAN JOURNAL OF MANAGED CARE
(2021)
Editorial Material
Medicine, General & Internal
Stacie B. Dusetzina
Summary: Relief may be in sight for Medicare Part D beneficiaries as the program is expected to be redesigned as part of the fiscal year 2022 budget reconciliation.
NEW ENGLAND JOURNAL OF MEDICINE
(2021)
Article
Surgery
Erin N. Lushin, Jennifer K. McDermott, Crystal Truax, Laura M. Lourenco, Mark Mariski, Jennifer I. Melaragno, Lisa M. Potter
Summary: This study assembled cases of transplant patients denied coverage by Medicare Part D prescription drug plans due to off-label use, revealing a critical flaw in the program where the referenced compendia are outdated and do not reflect best practices in organ transplantation.
AMERICAN JOURNAL OF TRANSPLANTATION
(2021)
Article
Oncology
David Samuel, Nicole S. Nevadunsky, Devin T. Miller, Sara Isani, Dennis Y. S. Kuo, Gregory M. Gressel
Summary: In 2016, there were gender-based, regional, and experience-related variations in opioid prescribing among gynecologic oncologists caring for Medicare-insured patients. Male physicians and those with more years of experience tended to have more opioid prescription claims, while physicians in the South had the greatest number of claims. Board certification in palliative care was also associated with higher opioid claims.
CURRENT PROBLEMS IN CANCER
(2021)
Article
Health Care Sciences & Services
Benedic N. Ippolito, Joseph F. Levy
Summary: This study compared the Medicare Part D market share of brand drugs with their net-to-list price ratio. The findings revealed a negative correlation between the net-to-list price ratio and the market share of drugs. The study suggests that greater exposure to the Medicare Part D market is associated with larger differences between net and list prices of drugs.
HEALTH SERVICES RESEARCH
(2023)
Article
Pharmacology & Pharmacy
Emily Nash Smyth, Bela Bapat, Daniel E. Ball, Thierry Andre, James A. Kaye
CLINICAL THERAPEUTICS
(2015)
Article
Geriatrics & Gerontology
Noam Y. Kirson, Urvi Desai, Ljubica Ristovska, Alice Kate G. Cummings, Howard G. Birnbaum, Wenyu Ye, J. Scott Andrews, Daniel Ball, Kristin Kahle-Wrobleski
Article
Economics
Emily Nash Smyth, Ilaria Conti, James E. Wooldridge, Lee Bowman, Li Li, David R. Nelson, Daniel E. Ball
JOURNAL OF MEDICAL ECONOMICS
(2016)
Article
Economics
Daniel M. Gilden, Joanna M. Kubisiak, Gerhardt M. Pohl, Daniel E. Ball, David E. Gilden, William J. John, Stewart Wetmore, Katherine B. Winfree
JOURNAL OF MEDICAL ECONOMICS
(2017)
Article
Neurosciences
Noam Y. Kirson, J. Scott Andrews, Urvi Desai, Sarah B. King, Sophie Schonfeld, Howard G. Birnbaum, Daniel E. Ball, Kristin Kahle-Wrobleski
JOURNAL OF ALZHEIMERS DISEASE
(2018)
Article
Geriatrics & Gerontology
Daniel M. Gilden, Joanna M. Kubisiak, Kristin Kahle-Wrobleski, Daniel E. Ball, Lee Bowman
JOURNALS OF GERONTOLOGY SERIES A-BIOLOGICAL SCIENCES AND MEDICAL SCIENCES
(2017)
Article
Economics
Furaha Kariburyo, Yuexi Wang, I-Ning (Elaine) Cheng, Lisa Wang, David Morgenstern, Igor Asner, Lin Xie, Eric Meadows, John Danella
JOURNAL OF MEDICAL ECONOMICS
(2017)
Article
Urology & Nephrology
Furaha Kariburyo, Yuexi Wang, I-Ning ( Elaine) Cheng, Lisa Wang, David Morgenstern, Lin Xie, Eric Meadows, John Danella, Michael L. Cher
Article
Health Care Sciences & Services
Daniel M. Gilden, Joanna M. Kubisiak, Kristin Kahle-Wrobleski, Daniel E. Ball, Lee Bowman
BMC HEALTH SERVICES RESEARCH
(2014)
Article
Endocrinology & Metabolism
S. Yu, R. T. Burge, S. A. Foster, S. Gelwicks, E. S. Meadows
OSTEOPOROSIS INTERNATIONAL
(2012)
Article
Public, Environmental & Occupational Health
Anita J. Chawla, Daniel S. Mytelka, Stephan D. McBride, Dave Nellesen, Benjamin R. Elkins, Daniel E. Ball, Anupama Kalsekar, Adrian Towse, Louis P. Garrison
PHARMACOEPIDEMIOLOGY AND DRUG SAFETY
(2014)
Article
Public, Environmental & Occupational Health
Eric S. Meadows, Beth D. Mitchell, Susan C. Bolge, Joseph A. Johnston, Nananda F. Col
Article
Geriatrics & Gerontology
Radhika Nair, Virginia S. Haynes, Mir Siadaty, Nick C. Patel, Adam S. Fleisher, Derek Van Amerongen, Michael M. Witte, AnnCatherine M. Downing, Leslie Ann Hazel Fernandez, Vishal Saundankar, Daniel E. Ball
Article
Economics
Christopher M. Whaley, Jennifer B. Bollyky, Wei Lu, Stefanie Painter, Jennifer Schneider, Zhenxiang Zhao, Xuanyao He, Jennal Johnson, Eric S. Meadows
JOURNAL OF MEDICAL ECONOMICS
(2019)
Article
Clinical Neurology
J. Scott Andrews, Urvi Desai, Noam Y. Kirson, Miriam L. Zichlin, Daniel E. Ball, Brandy R. Matthews
ALZHEIMERS & DEMENTIA-TRANSLATIONAL RESEARCH & CLINICAL INTERVENTIONS
(2019)