Medicare Beneficiaries??? Management of Capped Prescription Benefits
Bibliographic Data
| ID | 9099524 |
|---|---|
| Authors | Emily R Cox (0000-0002-6475-7665, Express Scripts Holding Company (United States), corresponding author), Cindy Jernigan, Stephen Joel Coons (0000-0001-7977-5156), Jolaine R Draugalis |
| Year | 2001 |
| Volume | 39 |
| Issue | 3 |
| Pages | 296-301 |
| Publication date | 2001-03-01 |
| Peer Reviewed | Yes |
| Open Access | No |
| Type | ARTICLE |
| Venue | Medical Care (JOURNAL) |
| Journal identifiers | ISSN: 0025-7079 • E-ISSN: 1537-1948 |
| Publisher | Ovid Technologies (Wolters Kluwer Health) (PUBLISHER) |
| DOI | 10.1097/00005650-200103000-00009 |
| PMID | 11242323 |
| OpenAlex | W1982358339 |
| Language | EN |
| Citations received | 9 |
| References cited | 10 |
BACKGROUND: Having annual dollar limits in prescription coverage is a type of benefit design unique to Medicare beneficiaries. This type of coverage is found predominantly within private Medigap policies and Medicare+Choice plans offering prescription coverage. OBJECTIVES: The purpose of this study was to determine the impact of capped prescription benefits on efforts to reduce out-of-pocket prescription expenses by beneficiaries at risk for reaching their cap. RESEARCH DESIGN: This design was quasi-experimental, with data obtained from self-administered questionnaires mailed to 600 Medicare HMO risk enrollees with capped prescription benefits. RESULTS: Data were collected on 378 Medicare enrollees for a 63% response rate. Approximately half of all respondents participated in > or =1 strategy to reduce their out-of-pocket prescription expenses. Participation in selected strategies included obtaining samples from physicians (39.2%), taking less than prescribed amounts (23.6%), and discontinuing prescribed medications (16.3%). Additionally, 15% of respondents indicated going without necessities, and 12% indicated borrowing money to pay for their prescriptions. Those who reached their prescription cap were more likely to participant in any one behavior (odds ratio [OR], 2.18), more likely to take less medication than prescribed (OR, 2.83), more likely to discontinue a medication (OR, 3.36), and more likely to obtain samples from their physician (OR, 2.02) compared with those who had not reached their prescription cap. CONCLUSIONS: Beneficiaries at risk for reaching their prescription cap are taking steps to reduce their out-of-pocket prescription costs. Although some behaviors would be considered prudent, other behaviors may be placing beneficiaries at risk for drug-related morbidity and mortality
Business · Family medicine · Liberian dollar · Logistic regression · Medical prescription · Medicare Part D · Odds · Odds ratio · Prescription drug · Finance · Health Systems, Economic Evaluations, Quality of Life · Internal Medicine · Medication Adherence and Compliance · Medicine · Nursing · Pharmaceutical Practices and Patient Outcomes
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| Unique citing works | 9 |
|---|---|
| Citations per year | 0,41 |
| Citation span | 2004 - 2011 (8) |
| Citation velocity | historical |
| Highly cited | No |
| Citation types | Neutral: 8 |