Presenter:

Chandrakala Ganesh

Authors:

Chandrakala Ganesh, Dennis Shea

Mon June 5, 2006 9:30-10:45 Room Alumni Lounge

Rationale: AD is projected to affect 14 million Americans by 2050. Technological advances have led to the approval of five drugs to treat AD. While the demand for these drugs has been rising rapidly since their introduction there is little nationally representative research available on individuals who use them. Findings from this study would help in integrating aspects of access, quality and costs of health care services such as prescription drugs for elderly with Alzheimer’s disease.

Objectives: This paper has three objectives: (1) to examine the trends in diffusion of AD drugs among community residing Medicare beneficiaries from 1993 to 2002, (2) to determine the racial, ethnic and socioeconomic disparities in diffusion of AD drugs, (3) to identify determinants of current and projected future costs of AD drugs.

Methodology: The paper uses data on community dwelling beneficiaries from the Medicare Current Beneficiary Survey, years 1993 to 2002, and data on health care systems from the 2003 Area Resource File. Analysis procedures would be conducted on three samples: beneficiaries with only a claims diagnosis of AD, beneficiaries with a claims diagnosis or a survey report of AD, and beneficiaries with a claims diagnosis of AD, survey report of AD, or other dementia diagnosis. This categorization would help in determining how the results would change based on varying sample definitions. Analyses procedures will include conducting basic descriptive analysis on the numbers and types of drugs that are used by elderly with AD. Hazard models will be used to estimate the trends and disparities in diffusion of AD drugs. Finally, costs would be estimated by a generalized linear model using gamma regression functions.

Results: Preliminary studies of the 2001 MCBS data show that 3.5 percent of the community-dwelling Medicare beneficiaries suffered from AD. In 2001, 31 percent of Medicare beneficiaries used AD drugs, compared to 1.4 percent in year 1999. In general, beneficiaries who were white, lived in urban areas, had higher education, with drug coverage had greater utilization rates of AD drugs than those who were black, in rural areas, with lower education, without drug coverage. In 2001, the mean annual total drug and out-of-pocket expenditures of beneficiaries using AD drugs were $2317 and $850 respectively, versus $1749 and $663 for beneficiaries not using AD drugs.

Conclusion: The introduction of several new drugs for the treatment of AD makes it an ideal candidate for the study of diffusion. Preliminary studies suggest that new drug technology for AD has a significant impact on health care utilization and health care costs