Cost-Related Medication Nonadherence and Spending on Basic Needs Following Implementation of Medicare Part D

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Abstract
In perhaps the most extensive restructuring of the Medicare system since its introduction in 1965, Congress passed the Medicare Prescription Drug Improvement and Modernization Act in the fall of 2003. Before the Medicare Prescription Drug Improvement and Modernization Act, millions of individuals who were elderly and disabled had insufficient or no insurance coverage for outpatient medications.1-3 In the face of these economic barriers, several large surveys in the United States have shown that older individuals have resorted to behaviors such as skipping doses, reducing doses, and letting prescriptions go unfilled.4-9 Such cost-related medication nonadherence (CRN) is associated with increased risk of myocardial infarction, stroke, and preventable hospitalization.10