Yuping Tsai , Jessica Leung , Tara C. Anderson , Fangjun Zhou , James A. Singleton
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引用次数: 0
Abstract
Introduction
The Inflation Reduction Act (IRA) eliminated cost sharing for Medicare Part D-covered vaccines but did not address the cost burden faced by Medicare beneficiaries who did not have prescription drug coverage. This study aimed to determine the characteristics of beneficiaries without prescription drug coverage and to assess the association between the receipt of a herpes zoster vaccine and prescription drug coverage status.
Methods
We used the 2019–2023 National Health Interview Survey and included Medicare beneficiaries aged 65 years and older who enrolled in both Parts A and B or a Medicare Advantage plan. Descriptive statistics were used to examine beneficiaries' characteristics. Logistic regressions were used to examine the associations between the receipt of a herpes zoster vaccine and Medicare prescription drug coverage.
Results
The study included 33,578 beneficiaries and 93.5 % of beneficiaries had prescription drug coverage. The prevalence of lacking prescription drug coverage was higher among beneficiaries who did not have a college degree, had family income below the poverty level, had no flu shot and well visit within the past year, and had no usual place for care. The probability of receiving a herpes zoster vaccine was higher among beneficiaries with prescription drug coverage than those without prescription coverage (45.2 % versus 25.3 %).
Conclusions
Herpes zoster vaccination disparities between beneficiaries with and without prescription drug coverage existed before the IRA. Because the IRA only addresses the cost barrier facing by beneficiaries with prescription drug coverage, vaccination disparities was greater after the IRA implementation.
导言:通货膨胀削减法》(IRA)取消了医疗保险 D 部分承保疫苗的费用分担,但并未解决没有处方药承保的医疗保险受益人所面临的费用负担问题。本研究旨在确定没有处方药保险的受益人的特征,并评估接种带状疱疹疫苗与处方药保险状况之间的关联:我们使用了 2019-2023 年全国健康访谈调查,纳入了年龄在 65 岁及以上、同时参加了 A 部分和 B 部分或医疗保险优势计划的医疗保险受益人。我们使用描述性统计来研究受益人的特征。逻辑回归用于研究接种带状疱疹疫苗与医疗保险处方药覆盖范围之间的关联:研究包括 33,578 名受益人,93.5% 的受益人有处方药保险。在没有大学学历、家庭收入低于贫困线、过去一年内没有接种过流感疫苗和接受过健康检查以及没有固定医疗场所的受益人中,没有处方药保险的比例较高。有处方药保险的受益人接种带状疱疹疫苗的概率高于没有处方药保险的受益人(45.2% 对 25.3%):结论:在实施 IRA 之前,有处方药保险和没有处方药保险的受益人之间就存在带状疱疹疫苗接种的差异。由于 IRA 只解决了有处方药保险的受益人所面临的费用障碍,因此在 IRA 实施后,接种疫苗的差距更大了。
期刊介绍:
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