Antibiotic Use Rose With Better Drug Coverage After Part D

In other study looking at Part D, drug benefit linked to reduced out-of-pocket expenditures
By Eric Metcalf
HealthDay Reporter

WEDNESDAY, Aug. 11 (HealthDay News) -- The use of antibiotics in older adults increased after their drug coverage improved with the implementation of the Medicare Part D drug benefit, and Part D has been linked to a drop in beneficiaries' out-of-pocket expenses on drugs, especially if they previously lacked drug coverage, according to research published in the Aug. 9/23 issue of the Archives of Internal Medicine.

In one study, Yuting Zhang, Ph.D., of the University of Pittsburgh, and colleagues analyzed data from older beneficiaries in a large Medicare Advantage plan for two years before and after implementation of Part D. They found that overall antibiotic use increased the most among individuals who didn't have previous drug coverage (relative odds ratio, 1.58). The use of quinolones and macrolides increased in particular compared to other subclasses.

In the other study, Christopher Millett, Ph.D., of the University of California in San Francisco, and colleagues analyzed data from 1,504 Medicare beneficiaries who participated in the 2005 and 2006 Medical Expenditure Panel Survey. In the year after the implementation of Part D, average annual out-of-pocket payment on medications fell 32 percent ($1,011 to $691) for all beneficiaries. For those without previous drug coverage who enrolled in a Part D plan, the decrease was 49 percent. However, those who didn't enroll also had a 32 percent reduction. Medicare beneficiaries who previously had pharmacy coverage through Medicaid had similar out-of-pocket medication expenditures.

"However, a question remains about whether the high public cost of providing pharmacy coverage through Medicare is worth the substantially lower financial benefit derived by beneficiaries," Millett and colleagues conclude.

A co-author of the first study disclosed a financial relationship with Highmark Inc.

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