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APHA Scientific Session and Event Listing

Shubing Cai and Katia Noyes, PhD, MPH. Department of Community and Preventive Medicine, University of Rochester, 601 Elmwood Avenue, Box 644, Rochester, NY 14642, 585-275-0369, shubing_cai@urmc.rochester.edu

Objective:To examine the effect of prescription drug coverage on annual drug expenditures and the number of medical events (acute hospitalizations and short-term nursing home admissions) among Medicare beneficiaries with diabetes. Methods: 1999 Medicare Current Beneficiaries Survey data were used (1,181 beneficiaries with diabetes among 13,200 survey participants). Social-demographic characteristics, insurance status, and health status were compared between diabetics with and without drug coverage using T-test and Chi-square test. Two-part expenditure models were used to examine the relationship between drug coverage and total drug expenditures. Standardized population approach was used to estimate the difference in drug expenditures between population with and without drug coverage, adjusting for other observed factors. Similarly, negative binomial models were developed to estimate the number of medical events in the standardized population. Standard errors were established by using bootstrapping. Results: 31% of the Medicare beneficiaries with diabetes did not have drug coverage. Beneficiaries with drug coverage were on average 2 years younger than those without drug coverage (P<0.0001). There was no significant difference in health status between the two groups. After adjusting for all observed factors, drug coverage increased the annual drug expenditures by $334 for diabetic beneficiaries (P <0.05), and tended to decrease the annual events of hospitalization by 0.11 (P =0.18). There was no significant effect of drug coverage on short- term nursing home admissions. Conclusions: While drug coverage may increase the overall drug expenditures, it may also improve health outcomes in Medicare beneficiaries with diabetes.

Learning Objectives:

• To examine the effect of prescription drug coverage on drug expenditures and health outcomes among Medicare beneficiaries with diabetes.

Keywords: Diabetes, Drug Use

Presenting author's disclosure statement:

Not Answered