 | The 131st Annual Meeting (November 15-19, 2003) of APHA |
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| The 131st Annual Meeting (November 15-19, 2003) of APHA |
Wenhui Wei, MA, MS, Ayse Akincigil, MA, Stephen Crystal, PhD, and Usha Sambamoorthi, PhD. Institute for Health, Health Care Policy, and Aging Research, Rutgers University, 30 College Ave, New Brunswick, NJ 08901
Objective: To examine gender differences in out-of-pocket prescription drugs (OOP-PD) expenditures and OOP-PD burden among elderly Medicare beneficiaries.
Study Design: Multiple years of data, 1992 through 1999, from the nationally representative Medicare Current Beneficiary Survey (MCBS) were used.Out-of-pocket expenditures were based on self-reports by the individuals. High OOP-PD burden was defined as spending greater than 10% of income on prescription drugs during the year. All bivariate and multivariate analyses were corrected for complex survey design. Multivariate techniques included OLS, logistic regressions with corrections for the complex survey design, and median regressions.
Population Studied: Community-dwelling Medicare beneficiaries aged 65 or older.
Principal Findings: Overall, OOP-PD expenditures constituted 60% of the total expenditures on prescription drugs. Throughout the 90s, women had significantly higher OOP-PD expenditures and burden than men. For example, in 1999, on average women spent 19% more than men ($446 versus $374). Similarly, a higher proportion of women than women had high OOP-PD burden (11% vs. 7%). Separate logistic regressions on high OOP-PD burden by gender revealed differences in predictors of burden for women and men. Comparisons of OOP-PD over the period between 1992 and 1999 indicated that although prescription drug coverage increased by about 20% from 1992 to 1999 for both groups, coverage was always lower for women than for men. Women continued to have higher OOP-PD burden than men and the proportion of women and men having high OOP-PD burden, after declining in the mid-1990s, have been increasing in recent years. Similarly, the gender disparities in OOP-PD burden, after declining in the mid-1990s, have been increasing in recent years.
Conclusion: Disparities in prescription drug expenditures and OOP-PD burden between men and women seem to be widening in recent years. While prescription drug coverage offered some protection against high OOP-PD burden for both men and women, both low-income women and men remain particularly vulnerable to high OOP-PD burden.
Implications for Policy, Delivery or Practice: Insurance coverage for prescription drugs under Medicare for elderly needs to be considered. Medicare reform proposals, programs designed to subsidize prescription drug expenditures, cost sharing policies and caps in prescription drug coverage plans need to be carefully designed so that all elderly especially those with low income, are protected from high OOP-PD spending and burden.
Primary Source of Funding: AHRQ Awards R03 HS13005-01 (Out of Pocket Prescription Drug Expenditures Among Elderly Women) and P20HS11825 (Rutgers Center for Health Services Research Development).
Learning Objectives:
Keywords: Gender, Medicare/Medicaid
Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.