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P3‐401: Impact of prescription drug coverage on use of anti‐dementia drugs
Nicole R. Fowler, Yi‐fan Chen. Alzheimer s & Dementia, 2011-07-01
Topic: Risk, prevention and care in population studies
Dementia is an incurable disease. The most promising advances in treatment include cholinesterase inhibitors and memantine. Use of these expensive medications is controversial due to limited evidence in achieving clinically meaningful improvements. While use has substantially increased, the relationship between insurance for drugs and uptake of anti-dementia drugs is unknown. Given the less robust evidence-base, we hypothesized that insurance for drugs would not impact use of anti-dementia drugs and that beneficiaries with less generous drug coverage would experience less use. A retrospective cohort study of Medicare managed care beneficiaries aged =65 years who were alive and continuously enrolled in one of the largest Medicare Advantage plans in Pennsylvania from 2003-2007 (n = 35,102). We describe the uptake of anti-dementia drugs before and after Medicare Part D's using pharmacy and medical claims. The primary independent variable in the negative binomial regression with GEE is the type of pharmacy benefit group: no quarterly pharmacy benefit limits (no cap) (n = 9,487); pharmacy benefit limits [quarterly limits of $150 (n = 2,662) or $350 (n = 19,104)]; or no drug coverage (n = 3,939). Before Part D, the no coverage group experienced the largest growth in use -1.85% in 2004, 2.18% in 2005, 3.50% in 2006 and 5.26% in 2007. 1,197 (3.4%) beneficiaries had at least one prescription pre-Part D and 1,846 (5.3%) post-Part D. Unadjusted increases in uptake among those with at least one prescription pre-Part D did not differ by insurance group. Multivariable analyses show increasing use within each insurance group is significant, yet the increasing rate between all the groups and the no cap intervention group is not statistically different.
Key findings
- Multivariable analyses show increasing use within each insurance group is significant, yet the increasing rate between all the groups and the no cap intervention group is not statistically different.
Why it matters
Use of anti-dementia drugs increased within each insurance group, but the rate of increase did not differ significantly between groups with different pharmacy benefit limits or no drug coverage. The study found no significant effect of drug coverage generosity on the rate of anti-dementia drug uptake.
Study details
- Study designcohort study
- Participants35,102
- Effect size1.85%; 2.18%; 3.50%
- Evidence strengthModerate
How this study scored 43/100
Published in a peer-reviewed journal, and it is a cohort study following people over time. Scored zero for randomised / blinded because the record does not state it. We have no data on senior author's track record, so that was left out: it earned 41 of the 96 points we could judge it on, which is 43 out of 100.
| Component | Points | Why |
|---|---|---|
| Journal tier | 7 / 10 | Tier 3 — peer-reviewed journal (Alzheimer s & Dementia) |
| Journal's citation record | 2 / 4 | Alzheimer s & Dementia: journal h-index 228 (OpenAlex, 2026-10-29) |
| Study design | 7 / 12 | A cohort study following people over time |
| Strength of evidence | 3 / 5 | Rated “moderate” in our summary |
| Peer-review validation | 10 / 10 | Peer-reviewed. Published as an article in a named peer-reviewed journal. |
| How recent | 1 / 5 | 2011 — within 20 year(s) of the newest study here |
| Sample size | 4 / 4 | 35,102 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 | 0 / 7 | Cited 0 times (OpenAlex, 2026-10-10) |
| Citations per year | 0 / 5 | 0.0 citations a year over 17 year(s) since 2011 |
| Impact for its field and year | 0 / 6 | Cited 0.0× 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 | Senior author's record not available — left out of this score |
| Institution's track record | 1 / 3 | University of Pittsburgh: institution h-index 1,470 (OpenAlex) |
| Multi-centre collaboration | 0 / 3 | OpenAlex lists 1 institution(s) in 1 country — scores zero (affiliation lists can be incomplete) |
| Indexed in PubMed | 1 / 2 | Not in PubMed, but has a DOI |
| Free to read | 0 / 2 | Behind a paywall — scores zero |
| Points | 41 / 96 | Scored on 19 of 20 parts. We have no data for the rest, so they are left out: 41 of the 96 points we could judge it on is 43 out of 100. |
| Total | 43 / 100 | — |
What each of these 20 components measures, and what this score is not →
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Cite this study APA, Vancouver, BibTeX · download .bib or .ris
Built from the record alzhub holds for this paper, not looked up. Volume, issue and page numbers are not held in the record. Check the citation against the original before you use it.
APA 7th
Fowler, N. R., & Chen, Y. (2011). P3‐401: Impact of prescription drug coverage on use of anti‐dementia drugs. Alzheimer s & Dementia. https://doi.org/10.1016/j.jalz.2011.05.1844
Vancouver
Fowler NR, Chen Y. P3‐401: Impact of prescription drug coverage on use of anti‐dementia drugs. Alzheimer s & Dementia. 2011. doi:10.1016/j.jalz.2011.05.1844.
BibTeX
@article{fowler2011-a1fc4a91,
author = {Fowler, Nicole R. and Chen, Yi‐fan},
title = {{P3‐401: Impact of prescription drug coverage on use of anti‐dementia drugs}},
journal = {Alzheimer s \& Dementia},
year = {2011},
doi = {10.1016/j.jalz.2011.05.1844},
url = {https://doi.org/10.1016/j.jalz.2011.05.1844}
}
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