Antibiotic use increases among elderly patients enrolled in Medicare Part D, study finds

CHICAGO As elderly patients have found improved coverage of prescription drugs after enrolling in Medicare Part D, their use of antibiotics has increased, according to a study published in the upcoming issue of the Archives of Internal Medicine.

The study, published in the Aug. 23 edition of the journal, involved an analysis of data on 35,102 patients two years before and two years after Medicare Part D went into effect. The expansion of prescription drug coverage was estimated to reduce out-of-pocket spending by 13% to 23%. Studies have indicated that patients are less likely to fill prescriptions or take drugs prescribed for chronic conditions as medication costs increase, so the researchers sought to find whether similar associations exist for use of antibiotics.

“We found that the use of antibiotics increased in response to reductions in out-of-pocket price after Part D implementation,” the authors wrote.

The increase was most pronounced among those who had started receiving coverage under Medicare Part D after previously having no coverage. On the one hand, the authors were encouraged that antibiotic use increased among patients with pneumonia, but they also found increases in antibiotic use among patients with diseases not treatable with antibiotics, such as acute respiratory tract infections like bronchitis, pharyngitis and sinusitis.

“Our study suggests that reimbursement may play a role in addressing the substantial role of inappropriate antibiotic use,” the authors wrote.

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