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Published Online: 15 June 2015

Part D Plan Switching Among Medicare Beneficiaries With Schizophrenia

Abstract

Objective:

Most Medicare schizophrenia patients were randomly assigned in 2006 to one of 409 benchmark plans. This study examined plan switching and factors affecting switching among beneficiaries with schizophrenia.

Methods:

The data were 2006 Medicare pharmacy data for three groups of schizophrenia patients: those with Medicaid coverage (“dual eligibles”; N=93,705), Medicare beneficiaries with a low-income subsidy (N=56,148), and Medicare beneficiaries without the subsidy (N=36,107). Switching frequency and how patient and plan characteristics affected switching were examined.

Results:

Beneficiaries who switched their Part D plan at least once included 10.7% of the dual eligibles, 9.8% of those with a subsidy, and 5.5% of those without. Several factors affected likelihood of switching, including age, geographic region, and proportion of prescriptions filled by beneficiaries who were covered or whose prescriptions required utilization review in the original plan.

Conclusions:

Plan switching among Medicare beneficiaries with schizophrenia was relatively infrequent but may be driven by the need for better drug coverage and less restrictive utilization policies.

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Information

Published In

Go to Psychiatric Services
Go to Psychiatric Services

Cover: Avenue of Oaks at Litchfield Plantation, by Elizabeth O'Neill Verner, circa 1940. Oil on board. The Morris Museum of Art, museum purchase; 1993.003. © Estate of Elizabeth O'Neill Verner/licensed by VAGA, New York City.

Psychiatric Services
Pages: 1105 - 1108
PubMed: 26073411

History

Received: 15 October 2014
Revision received: 9 December 2014
Accepted: 22 January 2015
Published online: 15 June 2015
Published in print: October 01, 2015

Authors

Details

Yuting Zhang, Ph.D.
Dr. Zhang and Dr. Baik are with the Department of Health Policy and Management and Mr. Talisa is with the Department of Biostatistics, all at the University of Pittsburgh, Pittsburgh, Pennsylvania (e-mail: [email protected]).
Victor Talisa
Dr. Zhang and Dr. Baik are with the Department of Health Policy and Management and Mr. Talisa is with the Department of Biostatistics, all at the University of Pittsburgh, Pittsburgh, Pennsylvania (e-mail: [email protected]).
Seo Hyon Baik, Ph.D.
Dr. Zhang and Dr. Baik are with the Department of Health Policy and Management and Mr. Talisa is with the Department of Biostatistics, all at the University of Pittsburgh, Pittsburgh, Pennsylvania (e-mail: [email protected]).

Funding Information

National Institute of Mental Health10.13039/100000025: R21 MH100721, RC1 MH088510
Funding for this research was provided by grants RC1 MH088510 and R21 MH100721 from the National Institute of Mental Health and by grant R01 HS018657 from the Agency for Healthcare Research and Quality.The authors report no financial relationships with commercial interests.

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