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50/100

✓ Peer-reviewed alzhub usefulness score 50 out of 100. Health systems and care delivery

Topic: Risk, prevention and care in population studies

Of enrollees, 15.9% entered the gap, 2.6% within the first 180 days; among gap enterers, only 6.7% exited again. Gap entry was significantly associated with female gender and all comorbidities, particularly dementia (39.5% gap entry rate) and diabetes (28.0%). Among dementia patients entering the gap, anti-dementia drugs (donepezil, memantine, rivastigmine, and galantamine) and atypical antipsychotic medications (risperidone, quetiapine, and olanzapine) together accounted for 40% of pre-gap expenditures. Among diabetic patients, rosiglitazone accounted for 7.2% of pre-gap expenditures. Having dementia was associated with twice the risk of gap exit. Certain chronically ill MAPD enrollees are at high risk of gap entry and exposure to unsubsidized medication costs. Clinically vulnerable populations should be counseled on how to best manage costs through drug substitution or discontinuation of specific, non-essential medications.

Cite this study APA, Vancouver, BibTeX · download .bib or .ris

APA 7th

Ettner, S. L., Steers, N., Duru, O. K., Turk, N., Quiter, E. S., Schmittdiel, J. A., et al. (2010). Entering and Exiting the Medicare Part D Coverage Gap: Role of Comorbidities and Demographics. Journal of General Internal Medicine. https://doi.org/10.1007/s11606-010-1300-6

Vancouver

Ettner SL, Steers N, Duru OK, Turk N, Quiter ES, Schmittdiel JA, et al. Entering and Exiting the Medicare Part D Coverage Gap: Role of Comorbidities and Demographics. Journal of General Internal Medicine. 2010. doi:10.1007/s11606-010-1300-6. PMID: 20217267.

BibTeX

@article{ettner2010-20217267,
  author  = {Ettner, Susan L. and Steers, Neil and Duru, Obidiugwu Kenrik and Turk, Norman and Quiter, Elaine S. and Schmittdiel, Julie A. and Mangione, Carol M.},
  title   = {{Entering and Exiting the Medicare Part D Coverage Gap: Role of Comorbidities and Demographics}},
  journal = {Journal of General Internal Medicine},
  year    = {2010},
  doi     = {10.1007/s11606-010-1300-6},
  pmid    = {20217267},
  url     = {https://doi.org/10.1007/s11606-010-1300-6}
}

Built from the record alzhub holds for this paper, not looked up. Volume, issue and page numbers are not held in the record. The record names 7 authors; APA and Vancouver show the first six, BibTeX and the downloads carry all of them. Check the citation against the original before you use it.

Key findings

Of enrollees, 15.9% entered the gap, 2.6% within the first 180 days; among gap enterers, only 6.7% exited again.
Gap entry was significantly associated with female gender and all comorbidities, particularly dementia (39.5% gap entry rate) and diabetes (28.0%).
Among dementia patients entering the gap, anti-dementia drugs (donepezil, memantine, rivastigmine, and galantamine) and atypical antipsychotic medications (risperidone, quetiapine, and olanzapine) together accounted for 40% of pre-gap expenditures.
Among diabetic patients, rosiglitazone accounted for 7.2% of pre-gap expenditures.
Having dementia was associated with twice the risk of gap exit.

Why it matters

This study examines which Medicare Part D enrollees entered the coverage gap, where they pay more for their drugs, and found that people with dementia had a high gap entry rate. It does not test any treatment for Alzheimer's disease, but notes that dementia patients' drug costs before the gap were largely for anti-dementia and antipsychotic medications.

Study details

Participants287,713
Effect size15.9%; 2.6%; 6.7%
Evidence strengthLow

How this study scored 50/100

Published in a peer-reviewed journal. Scored zero for study design and randomised / blinded because the record does not state it.

Component	Points	Why
Journal tier	7 / 10	Tier 3 — peer-reviewed journal (Journal of General Internal Medicine)
Journal's citation record	3 / 4	Journal of General Internal Medicine: journal h-index 283 (OpenAlex, 2026-10-29)
Study design	0 / 12	No study design recorded — scores zero, not guessed (not stated in the record — scored 0)
Strength of evidence	1 / 5	Rated “low” in our summary
Peer-review validation	10 / 10	Peer-reviewed. Published as an article in a named peer-reviewed journal.
How recent	1 / 5	2010 — within 20 year(s) of the newest study here
Sample size	4 / 4	287,713 participants
Effect reported	2 / 3	Effect reported as a number, without an interval or test
Studied in people	3 / 3	Studied in people (participant count stated)
Randomised / blinded	0 / 2	No randomisation or blinding stated — scores zero (not stated in the record — scored 0)
Times cited	3 / 7	Cited 18 times (OpenAlex, 2026-10-10)
Citations per year	1 / 5	1.0 citations a year over 18 year(s) since 2010
Impact for its field and year	4 / 6	Cited 8.9× the average for papers of its field and year (OpenAlex FWCI)
Cited by studies here	0 / 6	No other study in this library cites it
Still being cited	0 / 4	Cited 0 times in 2024–2026 (2026 still in progress; OpenAlex)
Senior author's track record	4 / 4	Last-listed author Carol M. Mangione: h-index 113 (OpenAlex, whole career)
Institution's track record	2 / 3	University of California, Los Angeles: institution h-index 1,923 (OpenAlex)
Multi-centre collaboration	1 / 3	OpenAlex lists 3 institution(s) in 1 country
Indexed in PubMed	2 / 2	Indexed in PubMed (PMID 20217267)
Free to read	2 / 2	Free to read
Total	50 / 100	—

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