Effect of Medicare Part D on Ethnoracial Disparities in Antidementia Medication Use.

Abstract

To examine ethnoracial disparities in antidementia medication use, accounting for implementation of Part D, and to evaluate the role of prescription drug coverage as a cause of antidementia medication disparities. Rotating panel of Medicare beneficiaries who participated in the Medicare Current Beneficiary Survey from 2003 to 2013. Nationally representative sample of Medicare fee-for-service (FFS) beneficiaries with dementia. Community-dwelling FFS Medicare beneficiaries with dementia (N=4,304). Antidementia medication use, defined as at least one prescription fill in a given year. Unadjusted antidementia medication use was 10-percentage points lower for ethnoracial minority beneficiaries before Part D was implemented in 2006 (p=.01). This difference was attenuated after adjusting for demographic and socioeconomic factors (6-percentage points; p=.10). Part D was associated with a 6-percentage point increase in use (p<.01). The increase in use associated with Part D was higher although not statistically significantly so in ethnoracial minority beneficiaries (8-percentage points, p=.08). Analyses of each ethnoracial group found a significant effect of Part D only in Hispanic/Latino beneficiaries (18-percentage points; p<.01, adjusted). Antidementia medication disparities were reduced with expanded prescription drug coverage through Medicare Part D. Increases in antidementia medication use for minority beneficiaries started after Part D was implemented, with the largest increases in use observed in Hispanic/Latino beneficiaries.