"We found that the use of antibiotics increased in response to reductions in out-of-pocket price after Part D implementation," the authors write. Relative to the comparison group, antibiotic use increased the most among participants who transitioned from no drug coverage to Medicare Part D. These individuals were more likely to fill prescriptions for any class of antibiotic, with the exception of sulfonamides, after Part D implementation than before. In addition, the two groups who had previously had limited drug coverage were more likely to fill prescriptions for broad-spectrum antibiotics after enrolling in Part D.
For pneumonia, part D implementation was associated with triple the rate of antibiotic treatment among those who previously lacked drug coverage. "Given the high mortality associated with community-acquired pneumonia among the elderly, the finding that changes in drug coverage improve the likelihood of treatment is encouraging," the authors write.
"However, we also found increases in antibiotic use for other acute respiratory tract infections (sinusitis, pharyngitis, bronchitis and non-specific upper respiratory tract infection) for which antibiotics are generally not indicated," the authors conclude. "Our study suggests that reimbursement may play a role in addressing the substantial role of inappropriate antibiotic prescribing and use."
Source-Eurekalert