(HealthDay News) – Compared to seniors with diabetes treated through Veterans Affairs (VA), Medicare beneficiaries with diabetes use two to three times more brand-name drugs, driving up costs substantially, according to research published online June 11 in the Annals of Internal Medicine.
Walid F. Gellad, MD, MPH, from the Veterans Affairs Pittsburgh Healthcare System, and colleagues retrospectively analyzed data from 1,061,095 Medicare Part D beneficiaries and 510,485 veterans aged ≥65 years with diabetes. The authors sought to identify the percentage of patients taking oral hypoglycemics, statins, and angiotensin-converting enzyme (ACE) inhibitors or angiotensin-receptor blockers (ARBs) who filled brand-name drug prescriptions and percentage of patients taking long-acting insulins who filled analogue prescriptions.
The researchers found that brand-name drug use in Medicare was two to three times that in the VA (oral hypoglycemics, 35.3% vs. 12.7%; statins, 50.7% vs. 18.2%; ACE inhibitors or ARBs, 42.5% vs. 20.8%; and insulin analogues, 75.1% vs. 27%). From the fifth to the 95th percentiles, adjusted hospital referral region (HRR)-level brand-name statin use ranged from 41–58.3% in Medicare and 6.2–38.2% in the VA. For each drug group there was lower brand-name drug use for the 95th-percentile HRR in the VA compared to the 5th-percentile HRR in Medicare. Medicare spending would have been $1.4 billion less in this population if brand-name drug use had matched that of the VA.
“Medicare beneficiaries with diabetes use two to three times more brand-name drugs than a comparable group within the VA, at substantial excess cost,” the authors write.