There is limited information on the protective value of Medicare Part D low‐income subsidies (). We compared responses to drug costs for recipients with near‐poor (≤200 percent of the Federal Poverty Level) and higher income beneficiaries without the .
Medicare Advantage beneficiaries in 2008.
We examined three drug cost responses using multivariate logistic regression: cost‐reducing behaviors (e.g., switching to generics), nonadherence (e.g., not refilling prescriptions), and financial stress (e.g., going without necessities).
Telephone interviews in a stratified random sample ( = 1,201, 70 percent response rate).
After adjustment, a comparable percentage of unsubsidized near‐poor (26 percent) and higher income beneficiaries reported cost‐reducing behaviors (23 percent, = .63); fewer beneficiaries reported cost‐reducing behaviors (15 percent, = .019 vs near‐poor). Unsubsidized near‐poor beneficiaries were more likely to reduce adherence (8.2 percent) than higher income (3.5 percent, = .049) and beneficiaries (3.1 percent, = .027). Near‐poor beneficiaries also more frequently experienced financial stress due to drug costs (20 percent) than higher income beneficiaries (11 percent, = .050) and beneficiaries (11 percent, = .015).
Low‐income subsidies provide protection from drug cost‐related nonadherence and financial stress. Beneficiaries just above the income threshold are most at risk for these potentially adverse behaviors.
Data Sources/Study Setting