Impact of Medicare Part D on Racial Disparities in Adherence to Cardiovascular Medications among the Elderly

Mustafa Hussein, Teresa M. Waters, Cyril F. Chang, James E. Bailey, Lawrence M. Brown, David K. Solomon

Research output: Contribution to journalArticlepeer-review

9 Scopus citations


Medicare Part D improved medication adherence among the elderly, but to date, its effect on disparities in adherence remains unknown. We estimated Part D impact on racial/ethnic disparities in adherence to cardiovascular medications among seniors, using pooled data from the Medical Expenditure Panel Survey (2002-2010) on 14,221 Medicare recipients (65+ years) and 3,456 near-elderly controls (60-64 years). Study sample included White, Black, or Hispanic respondents who used at least one cardiovascular medication. Twelve-month adherence was measured as having an overall proportion of days covered ≥80%. Adherence disparities were defined according to the Institute of Medicine framework. Using difference-in-differences logistic regression, we found Part D to be associated with a 16-percentage-point decrease in the White-Hispanic disparity in overall adherence among seniors, net of the change among controls. Black-White disparities worsened only among men, by 21 percentage points. Increasing access and improving quality of medication use among disadvantaged seniors should remain a policy priority.

Original languageEnglish
Pages (from-to)410-436
Number of pages27
JournalMedical Care Research and Review
Issue number4
StatePublished - Aug 1 2016

Bibliographical note

Funding Information:
The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: This study was supported by the American Heart Association, predoctoral fellowship award #14PRE18710068 (PI: Hussein).

Publisher Copyright:
© 2016 SAGE Publications.


  • MEPS
  • Medicare Part D
  • cardiovascular disease
  • medication adherence
  • racial disparities

ASJC Scopus subject areas

  • Health Policy


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