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Expanded prescription coverage and opioid use disorders

Evidence from Medicare Part D

Bibliographic Data

ID15448332
AuthorsRicardo B Ang (0000-0002-8218-2607, Tulane University, corresponding author)
Year2025
Volume59
Pages101536-101536
Publication date2025-09-23
Open AccessYes
TypeARTICLE
VenueEconomics & Human Biology (JOURNAL)
Journal identifiersISSN: 1570-677X • E-ISSN: 1873-6130
PublisherElsevier BV (PUBLISHER)
DOI10.1016/j.ehb.2025.101536
PMID40997713
OpenAlexW4414563812
LanguageEN
References cited25

Medicare Part D, implemented on January 2006, expanded subsidized outpatient prescription-drug coverage, including medication-assisted treatment (MAT) drugs, for adults aged 65 and older. Using 6.2 million discharge records from the 2001 to 2011 Healthcare Cost and Utilization Project National Inpatient Sample, I study how this policy influenced serious opioid use disorder (OUD) events. The analysis uses a difference-in-differences framework that compares OUD-related hospitalizations among 65- to 69-year-olds with those of 60- to 64-year-olds, and an event study confirms parallel trends before implementation. Part D lowered OUD-related hospital admissions by 158.3 per 100,000 discharges, a 53% decline from the pre-policy mean. The reduction is concentrated in admissions that include diagnoses of opioid abuse or dependence, whereas admissions related to opioid poisoning show little change. Larger proportional declines among Black and Hispanic adults and among men indicate that changes in drug coverage were accompanied by differences in outcomes across demographic groups. Estimates are robust across alternative specifications. By reducing out-of-pocket costs for MAT drugs covered by Part D, comprehensive prescription benefits can substantially cut avoidable hospital stays even when individual treatment uptake is not observed. These findings inform current debates on drug-benefit design for aging populations confronting opioid-related harm and illustrate how insurance coverage shapes health production later in life

Harm · Health care · Medical prescription · Medicare Part D · Opioid · Opioid use disorder · Prescription drug · Reimbursement · Subsidy · Healthcare Policy and Management · Medication Adherence and Compliance · Opioid Use Disorder Treatment

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    Open Access•Nasreen Khan, Robert Kaestner•INQUIRY The Journal of Health…•2009

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    Helen Levy, David R Weir•The Journals of Gerontology…•2009

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