Implementation of Medicare Part D and statin use among the elderly population with diabetes Article (Web of Science)

abstract

  • Abstract Objective The American Diabetes Association treatment guidelines recommend that patients with diabetes over 40 years of age with one or more risk factors for cardiovascular disease be prescribed statin medication. Despite the guideline, use of statins among elderly patients with diabetes is low. Medicare Part D was implemented in 2006 to increase affordability and access to prescription medications for Medicare enrollees. The main objective of this study was to analyse trend in statin users with diabetes before and after implementation of Part D. Methods Data were obtained from the Medical Expenditure Panel Survey for 2004–2008. Patients who were diabetic (ICD-9 code 250) and either elderly (≥65 years) or near elderly (57–64 years) were included in the analysis. Chi-square analysis was used to compare statin users before and after Part D for both the elderly and near-elderly populations. For elderly patients, trends in statin users were analysed for subpopulations based on gender, race/ethnicity, income, education level and perceived health status. A logistic regression analysis was conducted to identify factors that predicted use of statin. Key findings Between 2004 and 2008 patients who reported using statins increased from 55.05 to 61.25% for the elderly and from 54.99 to 55.89% for the near elderly. The elderly population had a significant increase in the percentage of patients reporting use of statins after the implementation of Part D (P = 0.002). Logistic regression identified post-Part D period (0.75, 95% confidence interval (CI) 0.60–0.94; P = 0.013), female gender (1.28, 95% CI 1.05–1.57; P = 0.013) and African-American race/ethnicity (1.53, 95% CI 1.19–1.96; P < 0.00) as significant predictors of reporting statin use among study population. Conclusion The study results imply that Part D may have influenced an increase in prescriptions of statins to elderly patients with diabetes. Logistic regression and trend analysis indicate that Part D was unable to reduce disparities in prescriptions for racial and gender subgroups.

authors

publication date

  • 2012

webpage

published in

number of pages

  • 5

start page

  • 191

end page

  • 196

volume

  • 3

issue

  • 4