Patient Out-of-Pocket Costs for Type 2 Diabetes Medications When Aging Into Medicare
Authors' conclusion
In this cohort study of individuals with T2D, the increase in spending upon reaching age 65 years (when most people enroll in Medicare) was associated with patient coinsurance in the coverage gap and catastrophic coverage phases of Medicare Part D. The increased patient cost burden at age 65 years and a modest reduction in overall T2D drug utilization suggest that as people with T2D age into Medicare, there is potentially an increase in nonadherence and diabetes complications.
Study context
- Population
- People in the US with diagnosed T2D, aged 58 to 72 years, with claims for T2D medications observed both before and after age 65 years (2012–2020)
- Participants
- 129,997 people
- Exposure
- Reaching age 65 years vs before age 65 years
- Outcome
- Patient out-of-pocket costs for T2D drugs per quarter (inflation adjusted to 2020 dollars)
Methodological detailsregression discontinuity design, prescription drug claims data (TriNetX Diamond Network), 7 years of follow-up
- Regression discontinuity design
- Prescription drug claims data (TriNetX Diamond Network)
- 7 years of follow-up
Main finding
As reported in the abstract
Increase in mean quarterly out-of-pocket costs at age 65 years (95% CI, $19.86-$26.22)
$23.04
Increase at the 95th percentile of spending, after utilization adjustment (95% CI, $51.48-$61.23)
$56.36
Observational data: associations, not effects.
Further findings
- Utilization decrease at age 65 years
- 5.3%
- Claims per quarter before age 65 years
- 3.40 (95% CI, 3.38-3.42)
- Claims per quarter after age 65 years
- 3.22 (95% CI, 3.21-3.24)
- Shift in composition of utilization, incl. increased insulin use, associated with additional increases in patient costs
Original publication
Composed by AI from the published abstract and checked against it. How Briefs are made →