ArticleArchives of general psychiatry2012
Effects of Medicare Part D coverage gap on medication and medical treatment among elderly beneficiaries with depression.
Article in Archives of general psychiatry, 2012. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers, 2 of them syntheses that pooled it.
What it found
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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
10 citing papers in PubMed, 2 syntheses or guidelines pooled it, 18 citations in OpenAlex.
- 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 financial incentives for prescribers.The Cochrane database of systematic reviews · 2015Pooled it
- Effects of Medicare Part D coverage gap closure on utilization of branded and generic drugs.Health economics · 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
- Functional Limitations, Medication Support, and Responses to Drug Costs among Medicare Beneficiaries.PloS one · 2015Article
- The January effect: medication reinitiation among Medicare Part D beneficiaries.Health economics · 2014Article
- Generic initiation and antidepressant therapy adherence under Medicare Part D.The American journal of managed care · 2013Article
- Adverse clinical events among medicare beneficiaries using antipsychotic drugs: linking health insurance benefits and clinical needs.Medical care · 2013Article
- The effect of the US Medicare Part D coverage gaps on medication use among patients with depression and heart failure.The journal of mental health policy and economics · 2012Article
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 at 1 institution in 1 country.
Funding
Abstract
contextMaintenance antidepressant pharmacotherapy in late life prevents recurrent episodes of major depression. The coverage gap in Medicare Part D could increase the likelihood of reducing appropriate use of antidepressants, thereby exposing older adults to an increased risk for relapse of depressive episodes.
objectivesTo determine whether (1) beneficiaries reduce antidepressant use in the gap, (2) the reduction in antidepressant use is similar to the reduction in heart failure medications and antidiabetics, (3) the provision of generic coverage reduces the risk of reduction of medication use, and (4) medical spending increases in the gap.
designObservational before-after study with a comparison group design. SETTING AND PATIENTS: A 5% random sample of US Medicare beneficiaries 65 years or older with depression (n = 65,223) enrolled in stand-alone Part D plans in 2007.
main outcome measuresAntidepressant pharmacotherapy, physician, outpatient, and inpatient spending.
resultsBeing in the gap was associated with comparable reductions in the use of antidepressants, heart failure medications, and antidiabetics. Relative to the comparison group (those who had full coverage in the gap because of Medicare coverage or low-income subsidies), the no-coverage group reduced their monthly antidepressant prescriptions by 12.1% (95% CI, 9.9%-14.3%) from the pregap level, whereas they reduced use of heart failure drugs and antidiabetics by 12.9% and 13.4%, respectively. Those with generic drug coverage in the gap reduced their monthly antidepressant prescriptions by 6.9% (95% CI, 4.8%-9.1%); this decrease was entirely attributable to the reduction in the use of brand-name antidepressants. Medicare spending on medical care did not increase for either group relative to the comparison group.
conclusionsThe Medicare Part D coverage gap was associated with modest reductions in the use of antidepressants. Those with generic coverage reduced their use of brand-name drugs and did not switch from brand-name to generic drugs. The reduction in antidepressant use was not associated with an increase in nondrug medical spending.
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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.