Jamison JoEllen Jarrett, Wang Junling, Surbhi Satya, Adams Samantha, Solomon David, Hohmeier Kenneth C, McDonough Sharon, Eoff James C
The University of Tennessee Health Science Center, College of Pharmacy, Pharmacy Student, 881 Madison Avenue, Memphis, TN 38163.
Professor, Health Outcomes and Policy Research, Department of Clinical Pharmacy, The University of Tennessee Health Science Center College of Pharmacy, 881 Madison Avenue, Room 221, Memphis, TN 38163.
Divers Equal Health Care. 2016;13(5):326-333. Epub 2016 Aug 23.
Prior to the implementation of Medicare Part D in the United States, inequalities were found to exist in the use of medications between minority and white beneficiaries. Despite improvements in medication affordability after Medicare Part D implementation, it is still not clear whether the characteristics of the program have improved drug utilization patterns among minorities to the same degree as whites. This review aims to determine whether there were barriers for Medicare Part D to realize its potential to improve prescription drug utilization patterns among minorities.
Google Scholar, PubMed, Sciencedirect and Scopus were used to conduct a comprehensive search of the literature published since 2003 when the Medicare Prescription Drug, Improvement, and Modernization Act (MMA) was passed, which authorized the establishment of the Part D program. All studies and documents related to the effects of Medicare Part D on minorities were included to present a relatively comprehensive review on the topic.
Evidence indicated that minorities are not equally benefiting from Medicare Part D prescription drug coverage compared to whites. Examples of characteristics of Medicare Part D that caused significant racial differences in drug utilization include the donut hole, the complexity and number of drug plans, and drug utilization management strategies.
Medicare Part D has increased access to prescription medications for the elderly. However, continued analysis and research of drug utilization patterns among minorities should be conducted to ensure that all enrollees regardless of race are benefiting equally from Medicare Part D. Identification of these barriers can provide insights on how to improve the program to allow minorities to benefit equally from the Medicare Part D program and remove health inequalities.
在美国实施医疗保险D部分之前，发现少数族裔受益人和白人受益人在药物使用方面存在不平等现象。尽管医疗保险D部分实施后药物可负担性有所改善，但该计划的特点是否使少数族裔的药物使用模式得到与白人相同程度的改善仍不清楚。本综述旨在确定医疗保险D部分在实现改善少数族裔处方药使用模式潜力方面是否存在障碍。
使用谷歌学术、PubMed、科学Direct和Scopus对自2003年《医疗保险处方药、改善和现代化法案》（MMA）通过以来发表的文献进行全面检索，该法案授权设立D部分计划。纳入所有与医疗保险D部分对少数族裔影响相关的研究和文件，以对该主题进行相对全面的综述。
有证据表明，与白人相比，少数族裔并未平等地从医疗保险D部分的处方药覆盖中受益。医疗保险D部分的一些特点导致药物使用方面存在显著种族差异，包括“甜甜圈洞”、药物计划的复杂性和数量以及药物使用管理策略。
医疗保险D部分增加了老年人获得处方药的机会。然而，应继续对少数族裔的药物使用模式进行分析和研究，以确保所有参保人，无论种族，都能平等地从医疗保险D部分中受益。识别这些障碍可以为如何改进该计划提供见解，以使少数族裔能够平等地从医疗保险D部分计划中受益，并消除健康不平等现象。
