Use of and spending on supportive care medications among Medicare beneficiaries with cancer

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• 作者：Ilene H. Zuckerman (1) (2)
  Amy J. Davidoff (1) (3)
  Mujde Z. Erten (4)
  Bruce Stuart (1)
  Thomas Shaffer (1)
  J. Samantha Dougherty (1) (5)
  Candice Yong (1)
  
• 关键词：Cancer ; Medicare ; Part D ; Supportive care
• 刊名：Supportive Care in Cancer
• 出版年：2014
• 出版时间：August 2014
• 年：2014
• 卷：22
• 期：8
• 页码：2185-2195
• 全文大小：216 KB
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• 作者单位：Ilene H. Zuckerman (1) (2)
  Amy J. Davidoff (1) (3)
  Mujde Z. Erten (4)
  Bruce Stuart (1)
  Thomas Shaffer (1)
  J. Samantha Dougherty (1) (5)
  Candice Yong (1)
  
  1. Peter Lamy Center on Drug Therapy and Aging, Pharmaceutical Health Services Research Department, University of Maryland School of Pharmacy, Baltimore, MD, USA
  2. IMPAQ International, LLC, 10420 Little Patuxent Parkway, Suite 300, Columbia, MD, 21044, USA
  3. Agency for Healthcare Research and Quality, Rockville, MD, USA
  4. Department of Surgery, University of Vermont College of Medicine, Burlington, VT, USA
  5. Pharmaceutical Research and Manufacturers of America, Washington, DC, USA
  
• ISSN：1433-7339

文摘

Purpose The study objective was to provide population-based estimates of supportive care medication (SCM) use among Medicare beneficiaries with cancer and determine factors related to SCM receipt. Methods This retrospective cohort study of community-based Medicare beneficiaries used the Medicare Current Beneficiary Survey (1997-007). Dependent variables comprised use and spending on SCMs for three medication classes: opioids, antidepressants/sedative/hypnotics (ASH), and antiemetics. Independent variables of interest were supplemental insurance coverage, cancer site, and treatment. Multivariate models determined factors affecting receipt of, and spending on, SCMs. We also compared SCM use and spending among beneficiaries with and without cancer in order to understand what portion of SCM use and spending could be attributed to cancer as opposed to other comorbid conditions. Results A total of 1,836 Medicare beneficiaries with cancer and 9,898 beneficiaries without cancer were eligible for the study. Beneficiaries with cancer were more likely to receive opioids, ASH, and antiemetics compared to non-cancer beneficiaries. Adjusted annual payments for antiemetics were on average $637 higher in with cancer versus without cancer (p--.01), while ASH payments were $184 lower (p--.01). Opioid spending was similar among cancer and non-cancer users. Relative to colon cancer, beneficiaries with prostate cancer were least likely to receive any of the three SCM classes. Receipt of antineoplastic treatment increased the probability of use of all three classes of SCMs. Insurance coverage did not influence the use of or spending on opioids or antiemetics, but was associated with both outcomes for ASH. The use of all three SCM classes was significantly lower during years before Part D implementation of the new Medicare Part D prescription drug benefit and was higher after implementation of Part D. Conclusion This study provides population-based information on SCM use among Medicare beneficiaries with cancer. Cancer site and treatment modality were important predictors of SCM use.