Featured Research

from universities, journals, and other organizations

Early study of outcomes from U.S. Medicare Part D can't explain North-South disparities, study finds

January 7, 2013
University of Maryland
A new study finds that in the U.S., Northern patients paid more, adhered more to key Medicare Part D drugs in first two years of the option.

Patients' access to diabetes and heart failure drugs through U.S. Medicare plans in the first two years of the Part D option did not guarantee proper therapy, researchers at the University of Maryland (UM) found in a nationwide study published today in the journal Health Affairs.

The study revealed that Medicare patients in the northern regions of the nation spent more for Part D drugs for the two conditions and tended to adhere better to taking them than did patients in southern regions.

All of the 10 lowest-spending areas were in southern states, and all of the 10 highest-spending areas were in northern or central states. Of the 50 lowest-cost regions, 43 were south of the 37th parallel, which extends roughly from the Virginia-North Carolina border to central California, and 43 of the 50 highest-cost regions were above that line.

"Is it because of the patients or the physicians?" lead researcher Bruce Stuart, PhD, asks rhetorically. "Well, patients can't get the drugs without the physicians. How well they take the drugs is up to the patients. We think it is more patient behavior than physician behavior. We are trying to find out what those factors might be. Why would there be regional differences in terms of patient behavior?"

Stuart is the Parke-Davis chair in geriatric pharmacotherapy at the UM School of Pharmacy, executive director of the Peter Lamy Center for Drug Therapy and Aging, and a professor in the Department of Pharmaceutical Health Services Research.

Researchers did not find any strong evidence of Medicare savings in treating diabetes and heart failure -- savings such as lower hospital costs or fewer medical services -- as a result of higher Part D spending.

"However, this is only half a story because there are several plausible conjectures behind these findings," says Stuart. "The (Part D) program came into play in 2006 and for many of the people who got the benefit, this could be the first time they were using the drugs." Also, these drugs are primarily for long-term benefit. "The answer is likely that it takes a while for these drugs to work," Stuart says.

Stuart says analysis of subsequent years of Part D will be needed to make firm conclusions as to the payoff in hospital costs and services for people using and adhering to the heart and diabetes drugs regimens. Stuart hopes to begin a follow-up study to replicate the first one.

For the first study, Stuart and his team analyzed a 5 percent random sample of the Medicare population from a database compiled by the Centers for Medicare and Medicaid Services. They chose heart failure and diabetes because managing those chronic conditions is heavily dependent on drugs, they are very common chronic diseases, and the drugs have been proved effective in clinical trials.

Stuart says the study team formed two preliminary "bottom lines." First, although the researchers couldn't find much difference in who was taking the drugs, they clearly found that among people who used them, regimen adherence was higher in the north and that made drug spending higher. "Then we asked, 'Do people who are spending more and having higher adherence have lower spending on Part A and Part B services to treat diabetes and heart failure?' Stuart explains. The researchers did not see that relationship, but when they looked at total Medicare costs, they found that regions in the South with lower adherence had higher average Medicare spending for all A and B services compared to northern regions.

"Discovering which regional factors are responsible for differences in medication practices should be a high priority," the researchers wrote in Health Affairs.

Story Source:

The above story is based on materials provided by University of Maryland. Note: Materials may be edited for content and length.

Journal Reference:

  1. Bruce Stuart, J. Samantha Shoemaker, Mingliang Dai, and Amy J. Davidoff. Regions With Higher Medicare Part D Spending Show Better Drug Adherence, But Not Lower Medicare Costs For Two Diseases. Health Affairs, 2013; 32: 120-126 DOI: 10.1377/hlthaff.2011.0727

Cite This Page:

University of Maryland. "Early study of outcomes from U.S. Medicare Part D can't explain North-South disparities, study finds." ScienceDaily. ScienceDaily, 7 January 2013. <www.sciencedaily.com/releases/2013/01/130107171338.htm>.
University of Maryland. (2013, January 7). Early study of outcomes from U.S. Medicare Part D can't explain North-South disparities, study finds. ScienceDaily. Retrieved July 31, 2014 from www.sciencedaily.com/releases/2013/01/130107171338.htm
University of Maryland. "Early study of outcomes from U.S. Medicare Part D can't explain North-South disparities, study finds." ScienceDaily. www.sciencedaily.com/releases/2013/01/130107171338.htm (accessed July 31, 2014).

Share This

More Health & Medicine News

Thursday, July 31, 2014

Featured Research

from universities, journals, and other organizations

Featured Videos

from AP, Reuters, AFP, and other news services

House Republicans Vote to Sue Obama Over Healthcare Law

House Republicans Vote to Sue Obama Over Healthcare Law

Reuters - US Online Video (July 31, 2014) The Republican-led House of Representatives votes to sue President Obama, accusing him of overstepping his executive authority in making changes to the Affordable Care Act. Mana Rabiee reports. Video provided by Reuters
Powered by NewsLook.com
Despite Health Questions, E-Cigs Are Beneficial: Study

Despite Health Questions, E-Cigs Are Beneficial: Study

Newsy (July 31, 2014) Citing 81 previous studies, new research out of London suggests the benefits of smoking e-cigarettes instead of regular ones outweighs the risks. Video provided by Newsy
Powered by NewsLook.com
Dangerous Bacteria Kills One in Florida

Dangerous Bacteria Kills One in Florida

AP (July 31, 2014) Sarasota County, Florida health officials have issued a warning against eating raw oysters and exposing open wounds to coastal and inland waters after a dangerous bacteria killed one person and made another sick. (July 31) Video provided by AP
Powered by NewsLook.com
Health Insurers' Profits Slide

Health Insurers' Profits Slide

Reuters - Business Video Online (July 30, 2014) Obamacare-related costs were said to be behind the profit plunge at Wellpoint and Humana, but Wellpoint sees the new exchanges boosting its earnings for the full year. Fred Katayama reports. Video provided by Reuters
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.


Breaking News:
from the past week

In Other News

... from NewsDaily.com

Science News

Health News

Environment News

Technology News


    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