Racial and Ethnic Disparities in Medication Adherence Among Privately Insured Patients in the United States
PloS one
G. Joyce et al.
2019
To examine the association between socioeconomic status (SES) and racial and ethnic disparities in medication adherence for three widely prescribed therapeutic classes.
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PND64 Trends and Disparities in Pharmaceutical Treatment for Alzheimers Disease and Related Dementia Patients
Value in Health
G. Joyce et al.
2019
Researchers have yet to identify therapies that can reverse or slow the progression of Alzheimer’s disease and related dementias (ADRD), but four prescription drugs (donepezil, galantamine, memantine, and rivastigmine) have been recommended in AD treatment guidelines, having shown effects on the symptoms of AD. Despite the potential of these drugs to at least partially reduce AD’s burden, relatively little is known about the current trends in the use of these drugs within the trajectory of dementia diagnoses and care. This study examines these trends, with specific attention to disparities in drug use across sex, race, and ethnicity.
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Generic Drug Price Hikes and Out-of-Pocket Spending for Medicare Beneficiaries
Health Affairs
Geoffrey Joyce et al.
2018
Recent increases in prices of longtime generic drugs have focused attention on competition in generic markets. We used Medicare Part D data for the period 2006–15 to examine sudden large price increases in generic drugs in the context of their base prices, duration, and accompanying changes in patients’ out-of-pocket spending. The fraction of drugs that at least doubled in price increased from 1.00 percent of generic products in 2007 to 4.39 percent in 2013. Almost all were initially low- or medium-price medications and not among the most widely used generics. Changes in out-of-pocket spending for these drugs were modest. However, the elevated prices persisted for two to five years. Data for 2011–15 showed similar trends.
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The Association of Multiple Anti-Hypertensive Medication Classes With Alzheimer’s Disease Incidence Across Sex, Race, and Ethnicity
PloS one
Geoffrey Joyce et al.
2018
In a retrospective cohort design, we examined the medical and pharmacy claims of a 20% sample of Medicare beneficiaries from 2007 to 2013, and compared rates of AD diagnosis for 1,343,334 users of six different AHT drug treatments, 65 years of age or older (4,215,338 person-years).
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Growing Number Of Unsubsidized Part D Beneficiaries With Catastrophic Spending Suggests Need For An Out-Of-Pocket Cap
Health Affairs
Geoffrey Joyce et al.
2018
Medicare Part D has no cap on beneficiaries’ out-of-pocket spending for outpatient prescription drugs, and, unlike Medicare Parts A and B, beneficiaries are prohibited from purchasing supplemental insurance that could provide such a cap. Historically, most beneficiaries whose annual Part D spending reached the catastrophic level were protected from unlimited personal liability by the Low-Income Subsidy (LIS). However, we found that the proportion of beneficiaries whose spending reached that level but did not qualify for the subsidy—and therefore remained liable for coinsurance—increased rapidly, from 18 percent in 2007 to 28 percent in 2015. Moreover, average total per person per year spending grew much more rapidly for those who did not qualify for the LIS than for those who did, primarily because of differences in price and utilization trends for the drugs that represented disproportionately large shares of …
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