An Analysis Of Medicare Expenditures And Associated Prescription
Drug Costs During The Period 1990-2000
ROBERT NEWSOME
Advisor: Paul E. Mazmanian, Ph.D.
Preceptor: Jack O. Lanier, Dr. P.H., FACHE
Objectives: This study employed a combination of secondary demographic and health data to discern whether, and if so, how, health cost trends for Medicare and prescription drugs have affected the elderly population starting in the last decade of the twentieth century. Specific attention was paid to Medicare enrollees who lack prescription drug benefits through some other type of health insurance policy. Data were examined to distinguish trends in growth of the aged population, related costs of medical care (concentrating on prescription drug expenditures), trends in number of study population without full-year drug coverage, and drug expenditures for those elderly with drug coverage versus those without.
Methods: The primary study population was those aged 65 years and over according to 1990 U.S. Census Bureau data. Published data from a variety of other sources were also used to examine a number of other trends in the population and health sector. A retrospective cohort study design assessed growth in the population of interest and related changes in health care expenditures, increasing reliance on prescription drugs and related costs, falling health insurance coverage of prescription drugs for the elderly, and increased numbers of elderly people with chronic health conditions who do not fill prescriptions because of cost-versus-income problems. Statistical analyses show percentage changes for these trends since 1990.
Results: Individuals aged 65 and above, as a portion of total population, increased to over 12.0% between 1980-2000. Data from Federal and Virginia agencies will indicate how the elderly population’s prescribed drug use and per capita drug expenditures have increased. The rising cost of prescription drugs and simultaneous fall in health plans’ drug coverage benefits have meant that seniors with no or inadequate drug coverage fail to fill prescriptions for financial reasons for at least part of each year, and this happens more frequently among those with multiple chronic health condition.
Conclusions: As the population of older Americans ages and increases, their pharmaceutical expenditures will continue to rise, especially for the disabled and those with chronic health conditions. The fact that ongoing trends indicate growing numbers of seniors are likely to face problems paying for required prescription drugs will lead to policy implications wherein many elderly people may require public assistance in acquiring their drugs, with the alternative of increasing endemic morbidity rates and earlier mortality among the aged.
