Impact of Medicare Part D on mental health treatment and outcomes for dual eligible beneficiaries with HIV
Year: 2018
Type: article
Abstract: Depression is common among women with HIV and untreated depression can result in poor quality of life and worsen HIV outcomes. Women with HIV who are dually enrolled in Medicaid and Medicare faced a potential disruption in medication access when Medicare Part D was implemented in 2006. The goal of this study was to estimate the effects of Medicare Part D implementation on antidepressant use, depressive symptoms, and hospitalization in Medicaid-Medicare dual eligible women with HIV. This study used 2003-2008 data from the Women's Interagency HIV Study. The effects of Medicare Part D were estimated using a difference-in-differences approach, adjusting for temporal trends using a matched control group of Medicaid-only enrollees. Before Medicare Part D implementation, dual eligibles differed from Medicaid-only enrollees in antidepressant use and hospitalization, despite having identical prescription drug coverage through Medicaid. For dual enrollees, the transition to Medicare Part D was not associated with changes in antidepressant use, depressive symptoms, or hospitalization. We did not find disruptive effects on antidepressant use and related outcomes among dual eligibles in this study. Stable antidepressant use may be due to better access to medical care for dual eligibles through Medicare both before and after Medicare Part D implementation, which may have eclipsed any effects of the transition. It may also signal that classification of antidepressants as a protected drug class under Medicare Part D was effective in preventing psychiatric medication disruption.
Source: AIDS Care
Institutions: University of North Carolina at Chapel Hill, Vanderbilt University, Georgetown University, Albert Einstein College of Medicine, State University of New York, SUNY Downstate Health Sciences University, University of California, San Francisco, Rush University, University of Southern California
Language: English
Subfield: Infectious Diseases
Field: Medicine
Domain: Health Sciences
Open Access status: green
Funders: National Institutes of Health, Agency for Healthcare Research and Quality, University of North Carolina at Chapel Hill, National Institute on Alcohol Abuse and Alcoholism, National Institute on Aging, National Heart, Lung, and Blood Institute, National Institute of Mental Health, National Institute on Drug Abuse, National Cancer Institute, National Institute on Deafness and Other Communication Disorders, National Institute of Allergy and Infectious Diseases, National Institute of Dental and Craniofacial Research, Cecil G. Sheps Center for Health Services Research, University of North Carolina, Chapel Hill, National Center for Advancing Translational Sciences, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Institute for Global Health and Infectious Diseases
Awards: Acute Effects of Cannabis on Cognition and Mobility in Older HIV-Infected and Uninfected Women", Emory R38 Research Training Program, Emory WIHS CRS - Longitudinal Cohort, UNC-CH TRAINING PROGRAM IN HEALTH SERVICES RESEARCH, The Connie Wofsy Women's HIV Study, Brooklyn Women's Interagency HIV Study (WIHS) V, Miami Womens Interagency HIV Study WIHS, WIHS Data Management and Analysis Center (WDMAC), Southern California Women's Interagency HIV Study Consortium, Chicago WIHS Consortium V (CWC), Washington Women's Interagency HIV/AIDS Study, Clinical and Translational Science Institute, Atlanta Clinical and Translational Science Institute (ACTSI) Renewal, University of North Carolina Womens Interagency HIV Study UNC WIHS, G7438855670, Women's Interagency HIV Study (WIHS-V), UAB-MISS WIHS Cohort, MACS/WIHS -CCS, Emory Specialized Center of Research Excellence (SCORE) on Sex Differences, UNC MACS/WIHS Combined Cohort Study Clinical Research Site, Surviving the HIV Epidemic (S/HE) in metropolitan Washington DC - Advancing knowledge through cohort studies, MACS/WIHS Combined Cohort Study: Cook County Clinical Research Site (CC_CRS), The University of North Carolina Center for AIDS Research, Atlanta MACS/WIHS Combined Cohort Study Clinical Research Site
OpenAlex ID: W2890566057