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The association between polypharmacy and health-related quality of life among older adults with prostate cancer.

INTRODUCTION: Older adults with prostate cancer (PC) are at risk of polypharmacy, which further complicates disease management and health-related quality of life (HRQoL). This study evaluated the association between polypharmacy and HRQoL among Medicare beneficiaries with PC. MATERIALS AND METHODS: This observational, retrospective study analyzed data from the Surveillance, Epidemiology, and End Results (SEER) Medicare Health Outcomes Survey (MHOS) data resource. Beneficiaries aged ≥65 and enrolled in Medicare Advantage Organizations were included if they had a PC diagnosis and continuously e

Использование и управление аптеками, принадлежащими страховщикам и управляющими пособиями в области фармацевтики в Медикаре.

IMORTANS: Все большую озабоченность в области нормативного регулирования вызывает преобладание аптек, принадлежащих интегрированным страховщикам и менеджерам по выплате пособий по аптекам (УБМ), или страховщикам-УПМ. Однако мало что известно о роли этих аптек в Медикаре, где защита сети аптек может повлиять на динамику рынка. ЦЕЛЬ: Оценить распространенность аптек, принадлежащих страховщикам, и степень, в которой страховщики-ПБР направляют пациентов в аптеки, которыми они владеют в Медикаре. DESIGN, SETTING, И УЧАСТНИКИ: В рамках этого межсекторального исследования использовались данные о прет

Совпадение в аннотации оригинала
IMPORTANCE: The prevalence of pharmacies owned by integrated insurers and pharmacy benefit managers (PBMs), or insurer-PBMs, is of growing r … harmacies they own in Medicare. DESIGN, SETTING, AND PARTICIPANTS: This cross-sectional study used Medicare Part D claims data on prescription fills for a 20% random sample of US beneficiaries enrolled from January 1 through December 31, 2021. Data were analyzed from March to November 2024. EXPOSURES: Prescription fills. MAIN OUTCOMES AND MEASURES: The main ou …

Medicaid Eligibility Loss Among Dual-Eligible Beneficiaries Before and During COVID-19 Public Health Emergency.

IMPORTANCE: Medicaid coverage loss can substantially compromise access to and affordability of health care for dual-eligible beneficiaries. … nd Medicaid at the beginning of a given year and who continuously received low-income subsidies for Medicare Part D prescription drug coverage were included in the sample. Multivariable regression models were used to examine beneficiary-level and plan-level factors associated with Medicaid loss. Data analyses were conducted between March 2023 and October 2023. E …

Psoriasis drugs in the medicare population: dermatologists' spending and prescription patterns.

PURPOSE: Over the past decade, many new biologic and small-molecule drugs have been approved for psoriasis. These specialty drugs tend to be expensive and place financial burden on the healthcare system as well as patients. This study aims to explore trends in Medicare Part D spending and prescription patterns for psoriasis drugs by dermatologists. METHODS: The Centers for Medicare and Medicaid Services' (CMS) Medicare Part D Public Use Files from 2013 to 2017 were utilized to examine prescription rates and pricing FDA-approved psoriasis drugs. RESULTS: From 2013 to 2017, psoriasis drugs acc…

Price and Adoption of Exhalation Delivery System With Fluticasone, 2018-2023.

FDA approved an exhalation delivery system with fluticasone (EDS-FLU) for treatment of chronic rhinosinusitis with (2017) and without (2024) nasal polyposis. Concerns have emerged that high prices may limit access, but little is known about the extent of adoption. We analyzed publicly available Securities and Exchange Commission filings and Medicare Part D spending data to characterize EDS-FLU utilization, spending, and prices between 2018 and 2023. During this period, annual EDS-FLU utilization and spending increased 10.3-fold (32,869 to 339,400 prescriptions) and 12-fold ($21.1 million to $2…

Identifying Dual-Eligible Beneficiaries With Long-Term Services and Supports Use in Medicare Enrollment Data.

Identifying dual-eligible beneficiaries who use Medicaid-funded long-term services and supports (LTSS) is difficult, hindering efforts to monitor use and improve quality. We demonstrate a strategy that uses only Medicare data to identify nursing home (NH) users and Medicaid home-and-community-based-service (HCBS) waiver participants by leveraging the fact that these groups exclusively qualify for zero cost-sharing in Part D. In a multistate cohort of low-income older adults, we identified Part D LTSS beneficiaries (dual-eligible beneficiaries with zero Part D cost-sharing) in Medicare enrollme

Examining Opportunities to Increase Savings From Medicare Price Negotiations.

IMPORTANCE: Allowing the US Centers for Medicare & Medicaid Services to negotiate prescription drug prices for Medicare may improve drug affordability. OBJECTIVE: To estimate savings from Medicare price negotiation under the Inflation Reduction Act (IRA) and examine opportunities to increase savings. DESIGN, SETTING, AND PARTICIPANTS: This cross-sectional, population-based study used data from 2020 Medicare prescription drug claims. The study was conducted and data were analyzed in 2022. EXPOSURES: Eligibility for Medicare price negotiation under the IRA and alternative criteria. MAIN OUTC

Medication oversupply in patients with diabetes.

BACKGROUND: Studies in integrated health systems suggest that patients often accumulate oversupplies of prescribed medications, which is associated with higher costs and hospitalization risk. However, predictors of oversupply are poorly understood, with no studies in Medicare Part D. OBJECTIVE: The aim of this study was to describe prevalence and predictors of oversupply of antidiabetic, antihypertensive, and antihyperlipidemic medications in adults with diabetes managed by a large, multidisciplinary, academic physician group and enrolled in Medicare Part D or a local private health plan. ME…

Herpes zoster vaccination among Medicare beneficiaries with and without prescription drug coverage.

INTRODUCTION: The Inflation Reduction Act (IRA) eliminated cost sharing for Medicare Part D-covered vaccines but did not address the cost burden faced by Medicare beneficiaries who did not have prescription drug coverage. This study aimed to determine the characteristics of beneficiaries without prescription drug coverage and to assess the association between the receipt of a herpes zoster vaccine and prescription drug coverage status. METHODS: We used the 2019-2023 National Health Interview Survey and included Medicare beneficiaries aged 65 years and older who enrolled in both Parts A and B …

Which drugs will Medicare negotiate next? Predicting selected drugs for Initial Price Applicability Year 2029.

BACKGROUND: The fourth cycle of the Medicare Drug Price Negotiation Program (MDPNP) for Initial Price Applicability Year (IPAY) 2029 will continue to include both Medicare Part B and Part D drugs while incorporating several important policy changes that affect eligibility and selection. These changes, including clarification of drug eligibility criteria, expiration of the temporary small biotech exception, and implementation of the biosimilar delay provision, may substantially influence which drugs are selected for negotiation. OBJECTIVE: To predict the Medicare Part B and Part D 20 drugs mos

Potentially Inappropriate Medication Use Following Hospital Discharge Among Medicare Beneficiaries.

OBJECTIVES: Medicare beneficiaries 65 years and older are susceptible to receiving potentially inappropriate medications (PIMs), for which t … italization differed between TM and MA. STUDY DESIGN: This observational study analyzed nationwide Medicare Part D Event files, TM fee-for-service claims, and MA encounter data from 2016 to 2019. It included 675,776 hospitalization episodes for Medicare beneficiaries 65 years and older with Part D prescription drug coverage. METHODS: We conducted a difference-i …

Loss of Subsidized Drug Coverage and Mortality among Medicare Beneficiaries.

BACKGROUND: A total of 14 million Medicare beneficiaries receive the Low-Income Subsidy (LIS), which reduces cost sharing in Medicare Part D. Losing the LIS may impede medication access and affect mortality. METHODS: Using 2015-2023 Medicare data, we identified dual-eligible Medicare-Medicaid beneficiaries, who automatically receive the LIS, and calculated annual rates of Medicaid and LIS loss. To examine the relationship between LIS loss and mortality, we leveraged a natural experiment arising from the relationship between the timing of Medicaid disenrollment and subsequent LIS loss. We comp…

Medicare Beneficiary Receipt of Methadone by Drive Time to Opioid Treatment Programs.

IMPORTANCE: To combat the ongoing opioid crisis, policy makers and public health officials are developing novel policies to increase the availability of medications for opioid use disorder (OUD). An important question is to what extent geographic availability of opioid treatment programs (OTPs) is associated with treatment receipt. Understanding this association may help with developing additional policies to increase medication for OUD dispensing and improve population health outcomes. OBJECTIVE: To quantify trends in dispensing methadone to Medicare beneficiaries based on proximity to an OT

Pharmacotherapy in Medicare beneficiaries with atrial fibrillation.

BACKGROUND: There are limited data regarding national patterns of pharmacotherapy for atrial fibrillation (AF) among older patients. Drug exposure data are now captured for Medicare beneficiaries enrolled in prescription drug plans. OBJECTIVE: To describe pharmacotherapy for AF among Medicare beneficiaries. METHODS: By using a 5% national sample of Medicare claims data, we compared demographic characteristics, comorbidity, and treatment patterns according to Medicare Part D status among patients with prevalent AF in 2006 and 2007. RESULTS: In 2006, 27,174 patients (29.3%) with prevalent AF …

Time Trends in Prescribing of Anxiolytic, Sedative, and Hypnotic Drugs in the United States.

PURPOSE: Sedative, anxiolytic, and hypnotic (sleep-promoting) medications are extensively prescribed in clinical practice. Most are benzodia … om the Centers for Medicare & Medicaid Services (CMS), providing federal health care coverage under Medicare Part D and Medicaid programs. Specific medications targeted were: BZ derivatives, zolpidem, and non-BZs taken for anxiety disorders and insomnia (buspirone, trazodone, and dual orexin receptor antagonists). FINDINGS: ClinCalc data indicated that prescribi …

Gabapentin, Concomitant Prescription of Opioids, and Benzodiazepines among Kidney Transplant Recipients.

BACKGROUND: Gabapentinoids, commonly used for treating neuropathic pain, may be misused and coprescribed with opioid and benzodiazepine, increasing the risk of mortality and dependency among kidney transplant recipients. METHODS: We identified adult kidney transplant recipients who enrolled in Medicare Part D in 2006-2017 using the United States Renal Data System/Medicare claims database. We characterized recipients' post-transplant concomitant prescription of gabapentinoids, opioids, and benzodiazepine stratified by transplant year and recipient factors (age, sex, race, and diabetes). We inv…

Benzodiazepine Prescribing from VA and Medicare to Dually Enrolled Older Veterans: A Retrospective Cohort Study.

BACKGROUND: There has been a reduction in BZD prescribing in the Veterans Affairs (VA) health care system since 2013. It is unknown whether the decline in VA-dispensed BZDs has been offset by Medicare Part D prescriptions. OBJECTIVES: To examine (1) whether, accounting for Part D, declines in BZD prescribing to older Veterans remain; (2) patient characteristics associated with obtaining BZDs outside VA and facility variation in BZD source (VA only, VA and Part D, Part D only). DESIGN: Retrospective cohort study with mixed effects multinomial logistic model examining characteristics associate…

Is patient insurance type related to physician recommendation, administration and referral for adult vaccination? A survey of US physicians.

This study evaluated physician practices and perceived barriers for influenza, tetanus, diphtheria, pertussis (Tdap), and zoster vaccination … nces may be related to financial barriers associated with adult vaccinations that are covered under Medicare Part D and involve patient out-of-pocket costs. Efforts to reduce financial barriers associated with adult vaccinations covered under Medicare Part D and to improve patient and physician knowledge could positively impact physician recommendation, administr …

The Prevalence of Diagnosis of Major Eye Diseases and their Associated Payments in the Medicare Fee-for-Service Program.

PURPOSE: To estimate the prevalence of diagnosis of major eye disorders and their associated payments, in total and per-person diagnosed, am … on among Medicare FFS beneficiaries and account for approximately 4.3% of Medicare Part B and 1% of Medicare Part D spending.