Hispanics cut medication adherence gap after Medicare Part D launch

American Heart Association Meeting Report Abstract 119

June 02, 2014

Study Highlights:

After the 2006 launch of Medicare’s prescription drug benefit, Hispanics reduced the gap for taking prescribed heart medicines by more than 15 percentage points.
Hispanics, African-Americans and white Medicare participants all improved medication adherence after Part D, with whites continuing to have the highest adherence rate.
African-Americans in Medicare appear to have fallen further behind in medication adherence.

EMBARGOED until 4 p.m. ET MONDAY, JUNE 2, 2014

BALTIMORE, June 2, 2014 ― 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 Survey for white, African-American and Hispanic Medicare seniors to find trends in medication adherence before and in the four years after the launch of Medicare Part D (2007-10).

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 percent.
Whites’ adherence rate improved 47 percent.
African-Americans’ adherence rate improved about 9 percent.

“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 in health outcomes, not just adherence.”

Co-authors are Teresa M. Waters, Ph.D.; David K. Solomon, Pharm.D.; and Lawrence M. Brown, Pharm.D., Ph.D. Author disclosures are on the abstract.

The study was funded as part of an American Heart Association Pre-doctoral Fellowship.

Additional Resources:

African-Americans and Heart Disease
Heart Disease in Hispanic Women
Researcher photo and infographic are available on the right column of the release link http://newsroom.heart.org/news/hispanics-cut-medication-adherence-gap-after-medicare-part-d-launch?preview=2898f929773ccd99a348513a53ccf587
Follow AHA/ASA news on Twitter @HeartNews #QCOR14.

NOTE: Presentation is 5 p.m. ET Monday, June 2, 2014.

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