Changes in Out-of-Pocket Drug Expenditures Among Medicare Beneficiaries With Dementia Under the Inflation Reduction Act: A Simulation Study.

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Tác giả: Joshua T Cohen, Karen M Freund, Pei-Jung Lin, Peter J Neumann, Natalia Olchanski, Yingying Zhu

Ngôn ngữ: eng

Ký hiệu phân loại:

Thông tin xuất bản: United States : Value in health : the journal of the International Society for Pharmacoeconomics and Outcomes Research , 2025

Mô tả vật lý:

Bộ sưu tập: NCBI

ID: 462631

 OBJECTIVES: We investigated how the Inflation Reduction Act (IRA) Medicare Part D benefit redesign may reduce out-of-pocket (OOP) drug expenditures for Medicare beneficiaries with dementia. METHODS: Using data from the Health and Retirement Study (HRS) linked with Medicare claims, we simulated post-redesign OOP drug spending by applying the 2025 prescription drug cost-sharing rules to each beneficiary's pre-redesign Part D medication utilization for 2016, adjusting for inflation. Our study population comprised HRS respondents aged 65 and older in 2016, enrolled in Medicare fee for service, with at least one Part D drug claim in 2016, and diagnosed with dementia between 2000 and 2016 (n = 1677). We compared pre-redesign and post-redesign annual OOP drug expenditures stratified by: (1) low-income subsidy (LIS) eligibility status
  (2) household income among non-LIS beneficiaries
  (3) comorbidity count, and 4) cognitive impairment severity. RESULTS: After the redesign, we project average annual OOP drug expenditures among LIS beneficiaries with dementia to decrease from 6 to 5-representing a 1, or 55%, reduction. In contrast, among non-LIS beneficiaries, average OOP drug expenditures is projected to decrease from 72 to 76, a 96, or 25% reduction. We project the reduction in OOP drug expenditures to be greater among beneficiaries with 6 to 8 comorbidities (45%) than among beneficiaries with fewer comorbidities (21%-26%). CONCLUSIONS: The Inflation Reduction Act Medicare Part D benefit redesign will reduce OOP drug spending for beneficiaries with dementia, resulting in potentially marked savings not only for low-income beneficiaries and beneficiaries with a high comorbidity burden but also for higher-income beneficiaries.
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