SynthesisJournal of the American Geriatrics Society2010
Changes in drug use and out-of-pocket costs associated with Medicare Part D implementation: a systematic review.
Synthesis in Journal of the American Geriatrics Society, 2010. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 29 papers, 5 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
29 citing papers in PubMed, 5 syntheses or guidelines pooled it.
- Pharmaceutical policies: effects of regulating drug insurance schemes.The Cochrane database of systematic reviews · 2022Pooled it
- A systematic umbrella review of the association of prescription drug insurance and cost-sharing with drug use, health services use, and health.BMC health services research · 2022Pooled it
- Medicare Part D's Effects on Drug Utilization and Out-of-Pocket Costs: A Systematic Review.Health services research · 2017Pooled it
- Pharmaceutical policies: effects of cap and co-payment on rational use of medicines.The Cochrane database of systematic reviews · 2015Pooled it
- Medicare part D and long-term care: a systematic review of quantitative and qualitative evidence.Drugs & aging · 2013Pooled it
- Mortality trends of renal diseases due to hypertension in adults: an analysis of gender, race, place of death, and geographical disparities in the United States from 1999 to 2020.International urology and nephrology · 2025Article
- Agreement of Medication Information Derived From EHR Data Compared to Medicare Insurance Claims: An Analysis of Biologic Disease-Modifying Antirheumatic Drugs.Pharmacoepidemiology and drug safety · 2024Article
- Unintended Consequences of Increased Out-of-Pocket Costs During Medicare Coverage Gap on Anticoagulant Discontinuation and Stroke.Advances in therapy · 2023Article
- Five-year impact of Medicare Part D coverage gap reform on drug expenditures and utilization.Health services research · 2022Article
- Assessment of Expected Out-of-Pocket Spending for Rheumatoid Arthritis Biologics Among Patients Enrolled in Medicare Part D, 2010-2019.JAMA network open · 2020Article
- Impact of Medicare Part D on mental health treatment and outcomes for dual eligible beneficiaries with HIV.AIDS care · 2019Article
- Socioeconomic Disparities in Mortality Among Women With Incident Breast Cancer Before and After Implementation of Medicare Part D.Medical care · 2017Article
- The Effect of Medicare Part D on Prescription Drug Spending and Health Care Use: 6 Years of Follow-up, 2007-2012.Journal of managed care & specialty pharmacy · 2017Article
- How Did Medicare Part D Affect Racial and Ethnic Disparities in Drug Coverage?The journals of gerontology. Series B, Psychological sciences and social sciences · 2016Article
- Hypertension Control Cascade: A Framework to Improve Hypertension Awareness, Treatment, and Control.Journal of clinical hypertension (Greenwich, Conn.) · 2016Article
- Pharmaceutical Cost-Saving Strategies and their Association with Medication Adherence in a Medicare Supplement Population.Journal of general internal medicine · 2015Article
- Did Medicare Part D Affect National Trends in Health Outcomes or Hospitalizations? A Time-Series Analysis.Annals of internal medicine · 2015Article
- Changes in drug coverage generosity and untreated serious mental illness: transitioning from Medicaid to Medicare Part D.JAMA psychiatry · 2015Article
- Medication affordability gains following Medicare Part D are eroding among elderly with multiple chronic conditions.Health affairs (Project Hope) · 2014Article
- Demand for prescription drugs under non-linear pricing in Medicare Part D.International journal of health care finance and economics · 2014Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors.
Funding
Abstract
Medicare Part D was implemented 4 years ago. Despite the fact that public-use Part D data were unavailable until late 2008, researchers have used alternate data to examine the effect of Part D on drug use and out-of-pocket costs. In a systematic review of Medline from 2006 to October 2009, the literature about drug use and costs after implementation and during the transition period and coverage gap was summarized. Studies presenting original results regarding drug use and costs after Part D implementation were included. Case reports and series and simulation studies were excluded. Of 552 originally identified articles, 26 met selection criteria: 13 regarding the overall effect of Part D in the year(s) after implementation, seven describing the Part D transition period, and six concerning the coverage gap. Part D implementation was associated with a 6% to 13% increase in drug use and a 13% to 18% decrease in patient costs. The transition period was associated with no significant changes in use or costs for elderly dual-eligible beneficiaries, but effects in other populations were mixed. Entry into the coverage gap was associated with a 9% to 16% decrease in drug use and increases in costs of up to 89%. In summary, studies examining disparate data regarding the implementation of Part D found consistent positive effects on drug use and costs but revealed unfavorable trends in the coverage gap. The effect of the Part D transition period remains unclear. Although public-use data will validate these results, policymakers can use the existing evidence to inform changes and enhancements to Part D immediately.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.