Elderly/Long-term Care

Elderly people who lack prescription drug coverage may not get needed medications for chronic conditions

Elderly Medicare patients who have prescription drug coverage are much more likely than those who don't to obtain needed medications for serious chronic conditions, according to a recent study supported in part by the Agency for Healthcare Research and Quality (HS10318). Also, people in this study who lacked drug coverage acquired fewer medications if they felt well than if they felt ill, whereas people with drug coverage acquired similar amounts of medications regardless of their perceived health status. This is important, because people who have significant chronic conditions need medications to prevent end-organ damage regardless of how they feel.

These findings raise questions about the recently enacted Medicare legislation, since the legislated drug benefit requires patients to make substantial out-of-pocket contributions to pay for medications, notes Barry G. Saver, M.D., M.P.H., of the University of Washington. Seniors who feel healthy, even those with serious, chronic conditions, may acquire fewer needed medications under the new legislation, according to Dr. Saver and his colleagues.

They tracked medication purchases, complete with the timing and duration of each prescription, among 3,073 elderly men and women enrolled in a Medicare+Choice program (a group-model HMO) in Washington State for at least 2 years. Study participants had been diagnosed with one or more chronic conditions (hypertension, diabetes, congestive heart failure, and/or coronary artery disease). Unlike studies that have adjusted only for income, this study also adjusted for wealth (home ownership and non-home assets), which can influence a senior's ability to purchase medications.

See "Prescription drug coverage, health, and medication acquisition among seniors with one or more chronic conditions," by J. Elizabeth Jackson, M.A., Mark P. Doescher, M.D., M.S.P.H., Dr. Saver, and Paul Fishman, Ph.D., in the November 2004 Medical Care 42(11), pp. 1056-1065.

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