Medicare coverage gap associated with reductions in antidepressant use in study

The Medicare Part D coverage gap was associated with reduced use of antidepressants in a study of beneficiaries 65 years or older with depression, according to a report by Archives of General Psychiatry.

Depression affects about 13 percent of Medicare beneficiaries age 65 and older, many of whom have chronic physical conditions. Maintenance medication has been shown to prevent recurrent episodes of . However, the structure of the Part D benefit, particularly the coverage gap, "imposes a serious risk for discontinuing maintenance antidepressant pharmacotherapy among senior beneficiaries," the authors write in the study background. Under current provisions in the Affordable Care Act, the coverage gap will not be closed until 2020, the study notes.

Yuting Zhang, Ph.D., and colleagues from the University of Pittsburgh, Pennsylvania, examined how older patients responded to the coverage gap by conducting a study that used a 5 percent random sample of Medicare beneficiaries 65 years or older with depression (n=65,223) who were enrolled in stand-alone Part D plans in 2007.

According to study results, being in the gap was associated with comparable reductions in the use of antidepressants, medications and antidiabetics. Relative to a comparison group that had full coverage in the gap because of or low-income subsidies, the no-coverage group reduced their monthly antidepressant prescriptions by 12.1 percent and reduced their use of heart failure drugs by 12.9 percent and oral antidiabetics by 13.4 percent. Beneficiaries with generic drug coverage in the gap reduced their monthly antidepressant prescriptions by 6.9 percent, a reduction attributable to reduced use of brand-name antidepressants, researchers note.

"If patients discontinue their appropriate abruptly, they could be placing themselves at risk for medication withdrawal effects and for relapse or recurrence. If they do not notice any effects, they might decide not to resume taking antidepressants. Thus, a gap in drug coverage could place older adults in harm's way, as a result of disruptions in appropriate maintenance antidepressant pharmacotherapy," the authors conclude.

More information: Arch Gen Psychiatry. 2012;69[7]:672-679.

add to favorites email to friend print save as pdf

Related Stories

Seniors in Medicare's doughnut hole decrease use of meds

Feb 03, 2009

Beneficiaries enrolled in Medicare Part D who reached a gap in health care coverage known as the "doughnut hole" were much less likely to use prescription drugs than those with an employer-based plan, according to a University ...

The Medicare donut hole: Now you're covered, now you're not

Mar 25, 2010

If you're older, a woman, and suffering from either dementia or diabetes, you are the most likely to be exposed to unsubsidized medication costs in the US. This is known as the coverage gap for enrollees of Medicare Part ...

Recommended for you

Mindfulness helps teens cope with stress, anxiety

8 hours ago

As the morning school bell rings and students rush through crowded corridors, teenagers in one Portland classroom settle onto mats and meditation pillows. They fall silent after the teacher taps a Tibetan ...

Study links suicide risk with insomnia, alcohol use

10 hours ago

A new study is the first to show that insomnia symptoms mediate the relationship between alcohol use and suicide risk, and that this mediation is moderated by gender. The study suggests that the targeted ...

Echolocation acts as substitute sense for blind people

16 hours ago

Recent research carried out by scientists at Heriot-Watt University has demonstrated that human echolocation operates as a viable 'sense', working in tandem with other senses to deliver information to people with visual impairment.

User comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.