Related Experiment Video
Updated: Jun 28, 2026
06:55
Inverse Probability of Treatment Weighting (Propensity Score) using the Military Health System Data Repository and National Death Index
Published on: January 8, 2020
Medicare Part D formulary coverage since program inception: are beneficiaries choosing wisely?
E Anne Jackson1, Kirsten J Axelsen
1Milliman, Inc, 111 Monument Cr, Ste 601, Indianapolis, IN 46204, USA. anne.jackson@milliman.com
The American Journal of Managed Care
|November 15, 2008
Summary
Medicare Part D drug formularies have improved since 2006, offering more drugs without restrictions. However, beneficiaries should compare plans annually to ensure optimal coverage and cost savings.
Area of Science:
- Health Policy
- Pharmaceutical Economics
- Geriatric Medicine
Background:
- The Medicare Part D prescription drug benefit program aims to provide affordable prescription drug coverage to seniors.
- Understanding changes in formulary composition is crucial for beneficiaries to make informed choices.
Purpose of the Study:
- To analyze the evolution of Medicare Part D formulary composition since the program's inception.
- To compare drug coverage in benchmark plans (eligible for full premium subsidy) versus non-benchmark plans.
Main Methods:
- Utilized publicly available data from the Centers for Medicare & Medicaid Services.
- Analyzed formulary coverage and enrollment for all Part D plans annually.
- Tracked coverage for 152 common brand-name and generic drugs prescribed to seniors.
Main Results:
- Since 2006, there has been an increase in drugs available without formulary restrictions.
- The number of drugs excluded from formularies has decreased over time.
- Beneficiaries, particularly those receiving subsidies, may not be actively re-evaluating plan options during open enrollment.
Conclusions:
- Annual re-evaluation of Medicare Part D plans is recommended for beneficiaries to ensure appropriate coverage.
- While all plans meet requirements, some offer more comprehensive drug coverage.
- Benchmark plan status significantly influences Medicare enrollment, necessitating careful oversight of formulary consistency.
Related Concept Videos
01:21Drug Dosing: Obese Patients
In the United States, obesity is a prominent concern. It is linked to heightened mortality rates due to increased occurrences of conditions such as hypertension, atherosclerosis, coronary artery disease, and diabetes compared to nonobese individuals. A patient is classified as obese if their actual body weight surpasses the ideal or desirable body weight by 20%, based on Metropolitan Life Insurance Company data. Ideal body weights consider average weights and heights for males and females...
01:24Dosage Regimen: Individualization
Individualization in dosing regimens is the customization of medication doses for individual patients. Its necessity arises from the goal of maximizing therapeutic benefits while minimizing risks. This approach is pivotal because human responses to drugs can vary widely; what is effective for one person may be inadequate or excessive for another. Interpatient (intersubject) variability refers to differences in drug responses between individuals, while intrapatient (intrasubject) variability...
01:01Dosage Regimens: Partial Pharmacokinetic Parameters
It is not uncommon for complete drug pharmacokinetic profiles to remain elusive in pharmacokinetics. This necessitates certain educated assumptions by pharmacokineticists to determine appropriate dosage regimens without comprehensive pharmacokinetic data from animal or human studies. One prevalent assumption is setting the bioavailability factor, denoted as F, to 1 or 100%. This assumption caters to the scenario where a drug doesn't achieve full systemic absorption, resulting in the patient...
01:28Dosage Regimens: Designs and Approaches
Designing a dosage regimen, which refers to the manner of drug administration, is a complex process involving the selection of drug dose, route, and frequency. This process is underpinned by pharmacokinetic parameters derived from tests and population averages. These parameters are then tailored to patient-specific variables such as diagnosis, demographics, and allergy status. Once therapy commences, therapeutic response monitoring is critical and achieved through clinical and physical...
01:15Drug Dosing: Geriatric Patients
Elderly individuals encompass a diverse population with varying degrees of age-related physiological changes. Defining the elderly presents challenges, as the geriatric population is often arbitrarily categorized as individuals older than 65. However, many individuals in this group lead active and healthy lives, with an increasing number surpassing 85 years and falling into the older elderly category. Physiological changes associated with aging impact performance capacity and homeostatic...
01:02Prescription, Nonprescription and Orphan Drugs
Prescription drugs require a prescription from a medical practitioner and can only be obtained from a pharmacy. They have many applications, including treating pain, anxiety, and hypertension.
The misuse and addiction to prescription drugs is a growing problem that can affect people of all age groups, specifically teenagers. This can happen when prescription medications are used in ways not intended by the prescriber, such as taking someone else's prescription or using medication for...
The misuse and addiction to prescription drugs is a growing problem that can affect people of all age groups, specifically teenagers. This can happen when prescription medications are used in ways not intended by the prescriber, such as taking someone else's prescription or using medication for...