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- Title
How Does Drug Treatment for Diabetes Compare between Medicare Advantage Prescription Drug Plans ( MAPDs) and Stand-Alone Prescription Drug Plans ( PDPs)?
- Authors
Erten, Mujde Z.; Stuart, Bruce; Davidoff, Amy J.; Shoemaker, J. Samantha; Bryant‐Comstock, Lynda; Shenolikar, Rahul
- Abstract
Objective To compare the use of guideline-recommended prescription medications for diabetes among Medicare beneficiaries enrolled in stand-alone prescription drug plans ( PDPs) with Medicare Advantage prescription drug plans ( MAPDs) in the presence of potential selection bias. Data Sources/Study Setting Centers for Medicare and Medicaid Services' Chronic Condition Data Warehouse (2006, 2007). Study Design Retrospective cross-sectional comparison of drug use and proportion of days covered ( PDC) for oral-antidiabetics, ACE-inhibitors/ ARBs, and antihyperlipidemics among PDP and MAPD enrollees with diabetes. We estimated 'naïve' regression models assuming exogenous plan choice and two-stage residual inclusion (2 SRI) models to study endogeneity in choice of Part D plan type. Data Collection/Extraction Methods We identified 111,290 diabetics based on ICD-9 codes in Medicare claims from a random 5 percent sample of Medicare beneficiaries in 2005 excluding dual eligibles. Principal Findings The naïve regression models indicated lower probability of drug use for oral-antidiabetics (−4 percent; p < .001) and ACE-inhibitors/ ARBS (−2 percent; p = .004) among PDP enrollees, but their PDC was higher (3-5 percent) for all drug classes ( p < .001). 2 SRI models produced no significant differences in any-use equations, but significantly higher PDC values for PDP enrollees for oral-antidiabetics and ACE-inhibitors/ ARBs. Conclusions We found similar overall use of recommended drugs in diabetes treatment and no consistent evidence of favorable or adverse selection into PDPs and MAPDs.
- Subjects
TREATMENT of diabetes; DRUG prescribing; MEDICARE Part D; MEDICARE Part C; MEDICAID eligibility; HYPOGLYCEMIC agents
- Publication
Health Services Research, 2013, Vol 48, Issue 3, p1057
- ISSN
0017-9124
- Publication type
Article
- DOI
10.1111/1475-6773.12016