Location is the key determinant of use of both effective and risky drug therapies for Medicare Part D beneficiaries, the prescription rates of which vary widely across the nation, according to a new report from the Dartmouth Atlas.
The report examines prescription drug use under Part D of Medicare's drug benefits, separating drugs into proven therapies for heart attack, diabetes or broken bones, discretionary medications and potential harmful medications. The following are eight key findings from the report.
• In 2010, the average Medicare Part D beneficiary filled 49 standardized 40-day prescriptions. This number was as high as 63 prescriptions (Miami) and as low as 39 prescriptions (Grand Junction, Colo.).
• Approximately 27 percent of Medicare Part D beneficiaries filled at least one high-risk prescription in 2010. This number was as high as 43 percent (Alexandria, La.) and as low as 14 percent (Rochester, Minn.). More than 6 percent filled two or more filled prescriptions for two or more high-risk prescriptions.
• Medicare Part D drug plan spending averaged $2,670 per beneficiary. This number was as high as $4,739 (Miami) and as low as $1,770 (St. Cloud, Minn.).
• Approximately 26 percent of prescriptions were filled as name-brands, rather than generics. This number was as high as 36 percent (New York City) and as low as 16.5 percent (La Cross, Wis.).
• Approximately 80 percent of heart attack patients filled at least one beta-blocker prescription seven to 12 months after discharge between 2008 and 2009. This number was as high as 91.4 percent (San Angelo, Texas) and as low as 62.5 percent (Salem, Ore.).
• Approximately 72 percent of heart attack patients filled at least one statin prescription seven to 12 months after discharge between 2008 and 2009. This number was as high as 91.3 percent (Ogden, Utah) and as low as 44.3 percent (Abilene, Texas).
• No region made the top 10 lists for both use of beta blockers and use of statins after heart attacks.
• Approximately 14 percent of fragility fracture patients received a drug to slow osteoporosis within six months of their fracture. This number was as high as 28 percent (Honolulu) and as low as 6.8 percent (Newark, N.J.).
The report concluded areas with risky or expensive prescribing trends contrary to guidelines should examine prescription practices in regions with appropriate cost and risk levels to improve healthcare quality under Medicare Part D, according to a news release.
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