PCN220 - The Impact Of Medicare Part D Drug Coverage On Total Prescription Drug Expenditures Among Cancer Patients In 2014

Abstract

To estimate the prevalence of cancer among Medicare beneficiaries, and examine the impact of Medicare Part D on total prescription drug expenditures among these patients. The study was a retrospective cross-sectional analysis, conducted using the Medical Expenditure Panel Survey (MEPS) data. Regression discontinuity model was adopted where the age 65 was the cutoff point. Patients (n=1796) aged 55 years old and above with cancer diagnosis in the MEPS data in 2014 were identified. Treatment group (n=733) was Medicare beneficiaries (65 years old and above) with cancer diagnose, excluding individuals who were dual eligible for Medicaid or other public health insurance than Medicare. Control group (n=440) was near-elderly (55-64 years old) individuals with cancer diagnose, excluding those covered by Medicare, Medicaid, or other public health insurance than Medicare. The average age for Medicare beneficiaries was 73.9 and the nearly-old group was 59.7. Medicare beneficiaries tend to have more comorbidities than the control group (4.6 vs 3.4), less likely to be married (56.6% vs 71.1%), and lower household income (8.6% vs 5.3% in the low-income category). The ethnicity and region composition were significantly different between the two groups. Treatment group has significantly more public insurance coverage than the control group (45.5% vs 1.4%). Medicare beneficiaries had higher mean and median total prescription drug expenditure than the nearly-old group (p<0.05). Around age 65, there was no sudden change of total prescription drug expenditure; however, the trends before and after age 65 were significantly different. Medicare beneficiaries claimed $14.3 (SE=7.2) less than near-elderly individuals for total prescription drug expenditure when holding other factors constant. Other indicators that significantly associated with the outcome measure are insurance type and BMI category. Eligible Medicare beneficiaries were associated with lower total prescription drug expenditure than near-elderly individuals when controlled for demographics and health status.