Hispanics cut medication adherence gap after Medicare Part D launch
Hispanics have reduced the gap with whites in taking prescribed heart medicines since the 2006 launch of Medicare's prescription drug benefit called Medicare Part D, according to a study presented at the American Heart Association's Quality of Care and Outcomes Research 2014 Scientific Sessions.
Researchers reviewed prescription drug data from the national Medical Expenditure Panel for African-American and Hispanic Medicare recipients to find trends in medication adherence in the four years after the launch of Medicare Part D (2001-10).
After Part D, adherence rates increased among all racial groups, although to different extents. Overall adherence increased most among whites and Hispanics, but only slightly among African-Americans. This led to a more than 15 percentage point decrease in the white-Hispanic gap but increased the white-African-American gap by more than 5 percentage points.
The study also showed that within Medicare:
- Hispanics' total group adherence rate improved about 60 percentage points.
- Whites' adherence rate improved 47 percentage points.
- African-Americans' adherence rate improved about 9 percentage points.
"Medication adherence is important because patients with chronic conditions such as high blood pressure or diabetes who often don't stick with their medicines are at greater risk for problems including heart attack, stroke and heart failure," said Mustafa Hussein, B.S. Pharm., M.S., the study's lead author and an American Heart Association pre-doctoral fellow in health outcomes and policy research at the University of Tennessee Health Science Center in Memphis. "We suspect that medication adherence disparities play a significant role in minority patients' rapid development of high blood pressure and heart disease."
Several factors might explain the differences between Hispanics and African-Americans: they may have been more aware of Part D's launch due to prior use of drug discount card programs. Hispanics are also more likely to use the Part D low-income subsidy and be enrolled in Medicare Advantage plans, which often offer their own drug coverage, he said.
"Healthcare providers should collaborate in creative ways to empower minorities to overcome issues that can interfere with their health care and medication adherence, such as stress, depression, financial problems and lack of family or social support," Hussein said. "We really need to think more about social disadvantage as the big picture that contributes to all the disparities to health outcomes, not just adherence."