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

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

March 8, 2012
The majority of Medicare beneficiaries with kidney failure participate in Medicare's Part D prescription drug coverage program, and most of these receive a low-income subsidy from the program, according to a study appearing ...

Reducing drug funding to Medicare patients will lead many to stop taking their medications

August 16, 2011
The lack of financial assistance to cover the cost of drugs to Medicare beneficiaries (the US government's health insurance program for people aged 65 or over, which currently covers 50 million US citizens) could result in ...

Patients often stop taking heart drugs during Medicare coverage gaps

April 17, 2012
Patients who paid for heart medications solely through Medicare were 57 percent more likely to not take them during coverage gaps compared to those who had a Part D low-income subsidy or additional insurance, according to ...

Recommended for you

How the shape and size of your face relates to your sexuality

September 19, 2017
Men and women with shorter, wider faces tend to be more sexually motivated and to have a stronger sex drive than those with faces of other dimensions. These are the findings from a study led by Steven Arnocky of Nipissing ...

Behavioral therapy increases connectivity in brains of people with OCD

September 19, 2017
UCLA researchers report that people with obsessive-compulsive disorder, when treated with a special form of talk therapy, demonstrate distinct changes in their brains as well as improvement in their symptoms.

People with schizophrenia have threefold risk of dying

September 18, 2017
People with schizophrenia are three times more likely to die, and die younger, than the general population, indicating a need for solutions to narrow this gap, according to research published in CMAJ (Canadian Medical Association ...

Cognitive scientists find that people can more easily communicate warmer colors than cool ones

September 18, 2017
The human eye can perceive millions of different colors, but the number of categories human languages use to group those colors is much smaller. Some languages use as few as three color categories (words corresponding to ...

Why bad sleep doesn't always lead to depression

September 18, 2017
Poor sleep is both a risk factor, and a common symptom, of depression. But not everyone who tosses and turns at night becomes depressed.

Happiness is not determined by childhood biomarkers

September 18, 2017
Happiness is not determined by childhood biological markers such as height or body fat, according to a team of European researchers involving UCL.

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.