Featured Research

from universities, journals, and other organizations

Improved drug coverage under Medicare associated with increases in antibiotic use

Date:
August 10, 2010
Source:
JAMA and Archives Journals
Summary:
Antibiotic use appears to have increased among older adults whose prescription drug coverage improved as a result of enrolling in Medicare Part D, with the largest increases for broad-spectrum, newer and more expensive drugs, according to a new report.

Antibiotic use appears to have increased among older adults whose prescription drug coverage improved as a result of enrolling in Medicare Part D, with the largest increases for broad-spectrum, newer and more expensive drugs, according to a report in the August 9/23 issue of Archives of Internal Medicine.

"Overuse of antibiotics is a common and important problem, potentially leading to unnecessary spending for prescription drugs, increased risks of adverse effects with no associated benefit and the development of antimicrobial resistance," the authors write as background information in the article. "Multiple programs have aimed to reduce inappropriate antibiotic use in inpatient and ambulatory care settings. Although many of these interventions have helped curb antibiotic prescribing for acute respiratory tract infections and other conditions, there may still be substantial room for additional reductions."

Several studies have shown that as medication costs increase, patients are less likely to fill prescriptions or take drugs prescribed for their chronic conditions. To assess whether similar associations exist for the use of antibiotics, Yuting Zhang, Ph.D., and colleagues at the University of Pittsburgh conducted a comparison group analysis among 35,102 older adults two years before and after implementation of Medicare Part D. This expansion of prescription drug coverage was estimated to reduce out-of-pocket spending between 13 percent and 23 percent.

Participants belonged to one of four groups: three intervention groups who had no or limited drug coverage between 2004 and 2006, and one comparison group that had stable drug coverage without caps through their employer throughout the four-year study. In January 2006, all participants in the three intervention groups enrolled in Medicare Part D, with standard benefits including a $250 deductible, a 25 percent co-insurance before drug spending reaches $2,250 and a 5 percent coinsurance for catastrophic costs (drug spending of more than $5,100 or out-of-pocket spending of more than $3,600).

"We found that the use of antibiotics increased in response to reductions in out-of-pocket price after Part D implementation," the authors write. Relative to the comparison group, antibiotic use increased the most among participants who transitioned from no drug coverage to Medicare Part D. These individuals were more likely to fill prescriptions for any class of antibiotic, with the exception of sulfonamides, after Part D implementation than before. In addition, the two groups who had previously had limited drug coverage were more likely to fill prescriptions for broad-spectrum antibiotics after enrolling in Part D.

For pneumonia, part D implementation was associated with triple the rate of antibiotic treatment among those who previously lacked drug coverage. "Given the high mortality associated with community-acquired pneumonia among the elderly, the finding that changes in drug coverage improve the likelihood of treatment is encouraging," the authors write.

"However, we also found increases in antibiotic use for other acute respiratory tract infections (sinusitis, pharyngitis, bronchitis and non-specific upper respiratory tract infection) for which antibiotics are generally not indicated," the authors conclude. "Our study suggests that reimbursement may play a role in addressing the substantial role of inappropriate antibiotic prescribing and use."


Story Source:

The above story is based on materials provided by JAMA and Archives Journals. Note: Materials may be edited for content and length.


Journal Reference:

  1. Hersh et al. Decreasing Out-of-pocket Costs of Antibiotics: The Good, the Bad, and the Unknown: Comment on "Ambulatory Antibiotic Use and Prescription Drug Coverage in Older Adults". Archives of Internal Medicine, 2010; 170 (15): 1314 DOI: 10.1001/archinternmed.2010.225

Cite This Page:

JAMA and Archives Journals. "Improved drug coverage under Medicare associated with increases in antibiotic use." ScienceDaily. ScienceDaily, 10 August 2010. <www.sciencedaily.com/releases/2010/08/100809161128.htm>.
JAMA and Archives Journals. (2010, August 10). Improved drug coverage under Medicare associated with increases in antibiotic use. ScienceDaily. Retrieved September 23, 2014 from www.sciencedaily.com/releases/2010/08/100809161128.htm
JAMA and Archives Journals. "Improved drug coverage under Medicare associated with increases in antibiotic use." ScienceDaily. www.sciencedaily.com/releases/2010/08/100809161128.htm (accessed September 23, 2014).

Share This



More Health & Medicine News

Tuesday, September 23, 2014

Featured Research

from universities, journals, and other organizations


Featured Videos

from AP, Reuters, AFP, and other news services

Liberia Pleads for Help to Fight Ebola

Liberia Pleads for Help to Fight Ebola

AP (Sep. 22, 2014) Liberia's finance minister is urging the international community to quickly follow through on pledges of cash to battle Ebola. Bodies are piling up in the capital Monrovia as the nation awaits more help. (Sept. 22) Video provided by AP
Powered by NewsLook.com
Ebola Doctor Says Border Controls Critical

Ebola Doctor Says Border Controls Critical

AP (Sep. 22, 2014) A Florida doctor who helped fight the expanding Ebola outbreak in West Africa says the disease can be stopped, but only if nations quickly step up their response and make border control a priority. (Sept. 22) Video provided by AP
Powered by NewsLook.com
Global Ebola Aid Increasing But Critics Say It's Late

Global Ebola Aid Increasing But Critics Say It's Late

Newsy (Sep. 21, 2014) More than 100 tons of medical supplies were sent to West Africa on Saturday, but aid workers say the global response is still sluggish. Video provided by Newsy
Powered by NewsLook.com
Sierra Leone in Lockdown to Control Ebola

Sierra Leone in Lockdown to Control Ebola

AP (Sep. 21, 2014) Sierra Leone residents remained in lockdown on Saturday as part of a massive effort to confine millions of people to their homes in a bid to stem the biggest Ebola outbreak in history. (Sept. 20) Video provided by AP
Powered by NewsLook.com

Search ScienceDaily

Number of stories in archives: 140,361

Find with keyword(s):
Enter a keyword or phrase to search ScienceDaily for related topics and research stories.

Save/Print:
Share:

Breaking News:

Strange & Offbeat Stories


Health & Medicine

Mind & Brain

Living & Well

In Other News

... from NewsDaily.com

Science News

Health News

Environment News

Technology News



Save/Print:
Share:

Free Subscriptions


Get the latest science news with ScienceDaily's free email newsletters, updated daily and weekly. Or view hourly updated newsfeeds in your RSS reader:

Get Social & Mobile


Keep up to date with the latest news from ScienceDaily via social networks and mobile apps:

Have Feedback?


Tell us what you think of ScienceDaily -- we welcome both positive and negative comments. Have any problems using the site? Questions?
Mobile: iPhone Android Web
Follow: Facebook Twitter Google+
Subscribe: RSS Feeds Email Newsletters
Latest Headlines Health & Medicine Mind & Brain Space & Time Matter & Energy Computers & Math Plants & Animals Earth & Climate Fossils & Ruins