The Impact of Medicare Part D on Out-of-Pocket Costs for Prescription Drugs, Medication Utilization, Health Resource Utilization, and Preference-Based Health Utility.

Objectives. To quantify the impact of Medicare Part D eligibility on medication utilization, emergency department use, hospitalization, and preference-based health utility among civilian non institutionalized Medicare beneficiaries. Study Design. Difference-in-differences analyses were used to estimate the effects of Part D eligibility on health outcomes by comparing a 12-month period before and after Part D implementation using the Medical Expenditure Panel Survey. Models adjusted for sociodemographic characteristics and health status and compared Medicare beneficiaries aged 65 and older with near elderly aged 55-63 years old. Principal Findings. Five hundred and fifty-six elderly and 549 near elderly were included. After adjustment, PartDwas associated with a U.S.$179.86 (p5.034) reduction in out-of-pocket costs and an increase of 2.05 prescriptions (p5.081) per patient year. The associations between Part D and emergency department use, hospitalizations, and preference- based health utility did not suggest cost offsets and were not statistically significant. Conclusions. Although there was a substantial reduction in out-of-pocket costs and a moderate increase in medication utilization among Medicare beneficiaries during the first year after Part D, there was no evidence of improvement in emergency department use, hospitalizations, or preference-based health utility for those eligible for Part D during its first year of implementation. [ABSTRACT FROM AUTHOR]