ArticleAnnals of internal medicine2013
Brand-name prescription drug use among Veterans Affairs and Medicare Part D patients with diabetes: a national cohort comparison.
Article in Annals of internal medicine, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 21 papers, 3 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
21 citing papers in PubMed, 3 syntheses or guidelines pooled it, 33 citations in OpenAlex.
- Influencers of generic drug utilization: A systematic review.Research in social & administrative pharmacy : RSAP · 2018Pooled it
- Medicare Part D's Effects on Drug Utilization and Out-of-Pocket Costs: A Systematic Review.Health services research · 2017Pooled it
- Comparing VA and Non-VA Quality of Care: A Systematic Review.Journal of general internal medicine · 2017Pooled it
- Strategies to Reduce Low-Value Cardiovascular Care: A Scientific Statement From the American Heart Association.Circulation. Cardiovascular quality and outcomes · 2022Review
- Association between physician adoption of a new oral anti-diabetic medication and Medicare and Medicaid drug spending.BMC health services research · 2019Article
- Potential Savings in Medicare Part D for Common Urological Conditions.Urology practice · 2018Article
- Effects of Guideline and Formulary Changes on Statin Prescribing in the Veterans Affairs.Health services research · 2017Article
- The Impact of Medication-Based Risk Adjustment on the Association Between Veteran Health Outcomes and Dual Health System Use.Journal of general internal medicine · 2017Article
- Trajectories of Diabetes Medication Adherence and Hospitalization Risk: A Retrospective Cohort Study in a Large State Medicaid Program.Journal of general internal medicine · 2016Article
- Agreement between Medicare pharmacy claims, self-report, and medication inventory for assessing lipid-lowering medication use.Pharmacoepidemiology and drug safety · 2016Article
- Generic Medication Prescription Rates After Health System-Wide Redesign of Default Options Within the Electronic Health Record.JAMA internal medicine · 2016Article
- VA and Medicare Utilization Among Dually Enrolled Veterans with Type 2 Diabetes: A Latent Class Analysis.Journal of general internal medicine · 2016Article
- Variation in Formulary Management Practices Within the Department of Veterans Affairs Health Care System.Journal of managed care & specialty pharmacy · 2016Article
- Using machine learning to examine medication adherence thresholds and risk of hospitalization.Medical care · 2015Article
- Tight glycemic control and use of hypoglycemic medications in older veterans with type 2 diabetes and comorbid dementia.Diabetes care · 2015Article
- Role of pharmacy services in accountable care organizations.Journal of managed care & specialty pharmacy · 2015Article
- Regional variation in use of a new class of antidiabetic medication among medicare beneficiaries: the case of incretin mimetics.The Annals of pharmacotherapy · 2015Article
- Geographic variation in cancer-related imaging: Veterans Affairs health care system versus Medicare.Annals of internal medicine · 2014Observational
- Teaching Wisely.Journal of graduate medical education · 2014Article
- Impact of medicare part D plan features on use of generic drugs.Medical care · 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
9 authors at 4 institutions in 1 country.
Funding
Abstract
backgroundMedicare Part D and the U.S. Department of Veterans Affairs (VA) use different approaches to manage prescription drug benefits, with implications for spending. Medicare relies on private plans with distinct formularies, whereas the VA administers its own benefit using a national formulary.
objectiveTo compare overall and regional rates of brand-name drug use among older adults with diabetes in Medicare and the VA.
designRetrospective cohort.
settingMedicare and the VA, 2008. PATIENTS: 1,061,095 Medicare Part D beneficiaries and 510,485 veterans aged 65 years or older with diabetes. MEASUREMENTS: Percentage of patients taking oral hypoglycemics, statins, and angiotensin-converting enzyme (ACE) inhibitors or angiotensin-receptor blockers (ARBs) who filled brand-name drug prescriptions and percentage of patients taking long-acting insulins who filled analogue prescriptions. Sociodemographic- and health status-adjusted hospital referral region (HRR) brand-name drug use was compared, and changes in spending were calculated if use of brand-name drugs in 1 system mirrored the other.
resultsBrand-name drug use in Medicare was 2 to 3 times that in the VA: 35.3% versus 12.7% for oral hypoglycemics, 50.7% versus 18.2% for statins, 42.5% versus 20.8% for ACE inhibitors or ARBs, and 75.1% versus 27.0% for insulin analogues. Adjusted HRR-level brand-name statin use ranged (from the 5th to 95th percentiles) from 41.0% to 58.3% in Medicare and 6.2% to 38.2% in the VA. For each drug group, the 95th-percentile HRR in the VA had lower brand-name drug use than the 5th-percentile HRR in Medicare. Medicare spending in this population would have been $1.4 billion less if brand-name drug use matched that of the VA. LIMITATION: This analysis cannot fully describe the factors underlying differences in brand-name drug use.
conclusionMedicare beneficiaries with diabetes use 2 to 3 times more brand-name drugs than a comparable group within the VA, at substantial excess cost.
Indexed as
Identifiers
What OpenQuestion holds
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.