Health Data Reveal Impact Of Medicare Part D's First Year

Armen Hareyan's picture

Medicare Part D Prescription Drug

Wolters Kluwer Health released findings on the market impact of the Medicare Part D prescription drug program's first year.

The company conducted a comprehensive statistical analysis of 2006 prescription data and today offered some conclusions about the true impact of the "donut hole" on patients and pharmaceutical companies. The donut hole refers to the $2,850 coverage gap inherent to the 2006 Medicare drug prescription plan.

"Many have predicted the outcomes of Medicare Part D, but this analysis looks at actual prescription data for the full year to uncover fundamental trends at the national level," said Chris Messner, Product Director in Wolters Kluwer Health's Healthcare Analytics business. "Our goal was to determine the true magnitude of the donut hole and to begin to draw some conclusions about the effects it had on patients and the industry as a whole."

Using a statistical sampling of the "standard eligible" patient segment, the study confirms many expected results while at the same time reveals several outcomes that were much harder to predict. For example, key national-level observations for 2006 include:

-- A total of 32% or 4.2 million Medicare Part D standard eligibles entered the donut hole by the end of the year


-- Generic utilization was much higher in Medicare Part D versus the commercial population with generics garnering 4-5% more market share vs. brands

-- Medicare Part D induced demand by 1.6% out of 4.3% total prescription growth

-- Patients taking multiple brand drugs entered the donut hole earlier; increased discontinuation of medication or switching to generics was noted

-- Of the top 10 most prescribed therapeutic classes, therapies where patients were least likely to drop or switch to a generic were Beta Blockers, Thyroid Hormones, and Diabetes

-- Therapies where enrollees were most apt to discontinue or switch include Anti-Ulcerants and Diuretics

-- The Medicare Co-Pay cycle remained more volatile than commercial due to how the benefit is administered

-- The Medicare Co-Pay also was on average $10-$15 more or 35-52% higher than commercial for standard eligibles

The study was compiled using Wolters Kluwer Health's Medicare Part D product suite, a powerful combination of information products designed to offer the most complete perspective on the impacts of Medicare Part D. The study examined the January-June cohorts and assigned Medicare Part D patients into three eligibility categories: Dual Eligibles, Subsidized Eligibles, and Standard Eligibles. It assigned the standard eligibles into their four benefit phases: Deductible, Co-pay/Coinsurance, Donut Hole, and Catastrophic.