Prescription Drug Adherence and Cost-Related Underuse in the Medicare Population

Abstract

Underuse of medical care and prescription drug adherence are health behaviors affected by financial pressures, demographic and socioeconomic characteristics, and health status of Medicare beneficiaries. Cost-related underuse is the avoidance of needed medical care or prescription drugs due to financial concerns about the cost of the treatment. The purpose of this project is to determine the characteristics associated with cost-related underuse and to evaluate how health policy changes and prescription drug coverage may affect that behavior. The project aims are threefold: (1) determine the change over time and relationship between prescription drug coverage and the underuse of other medical care due to cost within the Medicare population; (2) examine the effect of enrollment in the Medicare Part D partial Low Income Subsidy (LIS), a program that provides scaled premium assistance and a flat 15% co-insurance, on adherence within drug classes associated with cost-related underuse; and (3) test the effects of financial, patient, and disease characteristics on prescription drug adherence within the Medicare partial LIS population. This study will provide a broader understanding of the policy levers, such as the Medicare Part D Low Income Subsidy, that impact prescription drug behavior and underutilization of medical care by Medicare beneficiaries.