• Leonardo Tamariz, Claudia L Uribe, Jiacong Luo, John W Hanna, Daniel E Ball, Kelly Krohn, and Eric S Meadows.
• MedMining, a Geisinger Health System Business, Danville, PA 17822-4012, USA.
• Am J Manag Care. 2011 Nov 1; 17 (11): 753-9.

ObjectivesTo describe persistence with teriparatide and other biologic therapies in Medicare Part D plans with and without a coverage gap.Study DesignRetrospective (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").MethodsPatients taking alendronate (nonbiologic comparator), teriparatide, etanercept, adalimumab, interferon β-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.ResultsFor 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 β-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.ConclusionsFor 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.

44 keywords...

hide…