Medicare coverage gap associated with reductions in antidepressant use in study

July 2, 2012

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.

Explore further: Drug coverage of Medicare beneficiaries with kidney failure -- some surprising findings

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

Related Stories

Recommended for you

Following a friend leads to unsafe driving behavior

June 23, 2017

Have you ever tried following a friend in a car? It can stressful; if you don't keep up, you are likely to get lost. To avoid this, you may make unsafe driving manoeuvres to keep sight of the car ahead.

Tough times make for more impulsive pre-teens

June 23, 2017

The loss of a grandparent. Marital discord at home. Trouble with peers. When pre-teens are forced to deal with adverse life events such as these they tend to become more impulsive in their decision-making later in life. And ...

Video games can change your brain

June 22, 2017

Scientists have collected and summarized studies looking at how video games can shape our brains and behavior. Research to date suggests that playing video games can change the brain regions responsible for attention and ...

0 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.