University of West Florida, Pensacola, FL, USA.
Med Care Res Rev. 2020 Oct;77(5):442-450. doi: 10.1177/1077558718806437. Epub 2018 Oct 18.
The Affordable Care Act has put in place policies to gradually close the Medicare Part D coverage gap (donut hole). I examine the effect of this gradual closure on total and out-of-pocket prescription drug expenditures, as well as the number of prescriptions filled. The analysis shows a general increase in prescription use. There are also heterogeneous effects, with higher total expenditure groups seeing a decrease in their out-of-pocket prescription expenditures. This suggests that closure of the "donut hole" has led to an increase in prescription use that was previously curtailed and had an impact on the financial risk faced by Medicare recipients. This has implications for trends in prescription use and Medicare expenditures in the future, as the coverage gap is closed further.
平价医疗法案（Affordable Care Act）制定了相关政策，以逐步缩小医疗保险处方药部分的覆盖缺口（甜甜圈洞）。我考察了这种逐步缩小对处方药总支出和自付支出以及开处方数量的影响。分析显示，处方使用普遍增加。也存在异质效应，总支出较高的群体自付处方药支出减少。这表明，“甜甜圈洞”的关闭导致了此前被抑制的处方使用量的增加，并对医疗保险受益人的财务风险产生了影响。随着覆盖缺口的进一步缩小，这对未来的处方使用和医疗保险支出趋势有影响。
