The Impact of Medicare Part D on Medication Treatment of Hypertension

Authors

  • Yuting Zhang,

    1. Department of Health Policy and Management, University of Pittsburgh, 130 De Soto Street, Crabtree Hall A664, Pittsburgh, PA 15261
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    • Address correspondence to Yuting Zhang, Ph.D., Department of Health Policy and Management, University of Pittsburgh, 130 De Soto Street, Crabtree Hall A664, Pittsburgh, PA 15261; e-mail: ytzhang@pitt.edu. Judith R. Lave, Ph.D., Julie M. Donohue, Ph.D., are with the Department of Health Policy and Management, University of Pittsburgh, Pittsburgh, PA. Walid Gellad, M.D., M.P.H., is with the VA Pittsburgh, RAND Health, Pittsburgh, PA. Walid Gellad, M.D., M.P.H., is also with the Division of General Medicine, University of Pittsburgh, Pittsburgh, PA.

  • Julie M. Donohue,

    1. Department of Health Policy and Management, University of Pittsburgh, Pittsburgh, PA
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  • Judith R. Lave,

    1. Department of Health Policy and Management, University of Pittsburgh, Pittsburgh, PA
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  • Walid F. Gellad

    1. VA Pittsburgh, RAND Health, Pittsburgh, PA
    2. Division of General Medicine, University of Pittsburgh, Pittsburgh, PA
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Abstract

Objective. To evaluate Medicare Part D's impact on use of antihypertensive medications among seniors with hypertension.

Data Sources. Medicare-Advantage plan pharmacy data from January 1, 2004 to December 12, 2007 from three groups who before enrolling in Part D had no or limited drug benefits, and a comparison group with stable employer-based coverage.

Study Design. Pre–post intervention with a comparison group design was used to study likelihood of use, daily counts, and substitutions between angiotensin-converting enzyme inhibitors and angiotensin-II receptor blockers (ARBs).

Principal Findings. Antihypertensive use increased most among those without prior drug coverage: likelihood of use increased (odds ratio=1.40, 95 percent confidence interval [CI] 1.25–1.56), and daily counts increased 0.29 (95 percent CI 0.24–0.33). Proportion using ARBs increased from 40 to 46 percent.

Conclusions. Part D was associated with increased antihypertensive use and use of ARBs over less expensive alternatives.

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