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Expanding Medicare to include a drug benefit would reduce the financial burden on elders but might not greatly increase drug access

According to a recent study by researchers at the University of Wisconsin-Madison, each year from 1996 to 1999 less than 3 percent of elderly Medicare beneficiaries reported not getting the medications prescribed for them. Usually, this was due to economic reasons, but some elders simply didn't like the idea of taking medicines, according to the study, which was supported in part by the Agency for Healthcare Research and Quality (National Research Service Award training grant T32 HS00083).

Less than 4 percent of seniors most at risk of not getting needed drugs (those who had no drug coverage, were poor, and had at least one chronic health problem) did not get medicines prescribed for them. Among all seniors, less than 0.5 percent in any year reported not getting a medicine because prescriptions were not covered by Medicaid or other insurance.

These findings suggest that expanding Medicare to include a drug benefit may not greatly enhance seniors' access to prescribed medicines. However, according to the authors, the evidence does not suggest that seniors' burden and access to prescription drugs is optimal at present. They note that expansion of Medicare to include a drug benefit would likely reduce the financial burden of prescription drugs, promote quality of care by lessening the role of cost in physicians' prescribing behavior, and possibly reduce the use of informal mechanisms of distribution (such as drug samples, trips across international borders, and subsidies from charitable organizations and manufacturers).

For this study, the researchers used the 1996-1999 Medicare Current Beneficiary Survey (MCBS) to examine trends in nonacquisition of prescribed medicines among seniors. The MCBS highlights prescription drug coverage, use, and cost among noninstitutionalized Medicare beneficiaries.

More details are in "Do seniors get the medicines prescribed for them? Evidence from the 1996-1999 Medicare Current Beneficiary Survey," by Mr. Craig, David H. Kreling, and David A. Mott, in the May 2003 Health Affairs 22(3), pp. 175-182.

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