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Medicare Part D is Associated With Reducing the Financial Burden of Health Care Services in Medicare Beneficiaries With Diagnosed Diabetes

Li, Rui PhD*; Gregg, Edward W. PhD*; Barker, Lawrence E. PhD*; Zhang, Ping PhD*; Zhang, Fang PhD; Zhuo, Xiaohui PhD*; Williams, Desmond E. MD, PhD*; Soumerai, Steven B. PhD

doi: 10.1097/MLR.0b013e3182a53d95
Original Articles

Background: Medicare Part D, implemented in 2006, provided coverage for prescription drugs to all Medicare beneficiaries.

Objective: To examine the effect of Part D on the financial burden of persons with diagnosed diabetes.

Research Design, Subjects, and Outcome Measures: We conducted an interrupted time-series analysis using data from the 1996 to 2008 Medical Expenditure Panel Survey (11,178 persons with diabetes who were covered by Medicare, and 8953 persons aged 45–64 y with diabetes who were not eligible for Medicare coverage). We then compared changes in 4 outcomes: (1) annual individual out-of-pocket expenditure (OOPE) for prescription drugs; (2) annual individual total OOPE for all health care services; (3) annual total family OOPE for all health care services; and (4) percentage of persons with high family financial burden (OOPE ≥10% of income).

Results: For Medicare beneficiaries with diabetes, Part D was associated with a 28% ($530) decrease in individual annual OOPE for prescription drugs, a 23% ($560) reduction in individual OOPE for all health care, a 23% ($863) reduction in family OOPE for all health care, and a 24% reduction in the percentage of families with high financial burden in 2006. There were similar reductions in 2007 and 2008. By 2008, the percentage of Medicare beneficiaries with diabetes living in high financial burden families was 37% lower than it would have been had Part D not been in place.

Conclusions: Introduction of Part D coverage was associated with a substantial reduction in the financial burden of Medicare beneficiaries with diabetes and their families.

*Division of Diabetes Translation, Centers for Disease Control and Prevention, Atlanta, GA

Department of Population Medicine, Harvard Medical School, Harvard Pilgrim Health Care Institute, Boston, MA

S.B.S. was partially supported by the Natural Experiments for Translation in Diabetes (NEXT-D) study, RFA-DP10-002, sponsored by CDC and NIDDK.

The findings and conclusions in this presentation are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention.

Study results were presented at the American Society for Health Economists 4th Biannual Conference at Minneapolis, Minnesota, June 10–13, 2012; and at the AcademyHealth Annual Research Meeting, Orlando, Florida, June 24–26, 2012.

The authors declare no conflict of interest.

Reprints: Rui Li, PhD, Division of Diabetes Translation, Centers for Disease Control and Prevention, 4770 Buford Highway NE, MS F-73, Atlanta, GA 30341. E-mail:

© 2013 by Lippincott Williams & Wilkins.