Persistence with biologic therapies in the medicare coverage gap

Leonardo Tamariz, Claudia L. Uribe, Jiacong Luo, John W. Hanna, Daniel E. Ball, Kelly Krohn, Eric S. Meadows

Research output: Contribution to journalArticlepeer-review

6 Scopus citations

Abstract

Objectives: To describe persistence with teriparatide and other biologic therapies in Medicare Part D plans with and without a coverage gap. Study Design: Retrospective (2006) cohort study of Medicare Part D prescription drug plan beneficiaries from a large benefits company. Two plans with a coverage gap (defined as "basic") were combined and compared with a single plan with coverage for generic and branded medications (defined as "complete"). Methods: Patients taking alendronate (nonbiologic comparator), teriparatide, etanercept, adalimumab, interferon ®-1a, or glatiramer acetate were selected for the study. For patients with complete coverage, equivalent financial thresholds were used to define the "gap." The definition of discontinuation was failure to fill the index prescription after reaching the gap. Results: For alendronate, 27% of 133,260 patients had enrolled in the complete plan. Patients taking biologic therapies had more commonly enrolled in complete plans: teriparatide (66% of 6221), etanercept (58% of 1469), adalimumab (52% of 824), interferon &βετα;-1a (60% of 438), and glatiramer acetate (53% of 393). For patients taking either alendronate or teriparatide, discontinuation rates were higher in the basic, versus complete, plan (adjusted odds ratios, 2.02 and 3.56, respectively). Discontinuation did not significantly vary by plan type for etanercept, adalimumab, interferon β-1a, or glatiramer acetate. Conclusions: For patients who reached the coverage gap, discontinuation was more likely for patients taking osteoporosis (OP) medication. Not having a coverage gap was associated with improved persistence with OP treatment.

Original languageEnglish (US)
Pages (from-to)753-759
Number of pages7
JournalAmerican Journal of Managed Care
Volume17
Issue number11
StatePublished - Nov 1 2011

ASJC Scopus subject areas

  • Health Policy

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