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Study Says Higher Medication Spending Doesn't Indicate Better Prescribing Quality
The findings, published in the Nov. 3 Online First issue of the New England Journal of Medicine, reveal great variation across the country in both drug spending and the rate of inappropriate prescriptions for the elderly.
Lead investigator Yuting Zhang, Ph.D., assistant professor of health economics at GSPH, said that even after demographic characteristics such as age and sex, individual health status and insurance coverage are taken into account, it's clear that Medicare drug spending varies broadly among hospital-referral regions (HRRs).
"Higher spending can be justified if it's for drugs that are necessary and appropriate and improve patients' health," she said. "But if certain drugs are being incorrectly prescribed to seniors, then that can lead to complications and expensive interventions, such as hospitalization. As we try to reform health care to get costs under control, we need a better understanding of how spending differs regionally to make a positive impact."
Dr. Zhang and her colleagues assessed two measures of prescription quality from the Healthcare Effectiveness Data and Information Set (HEDIS). One measure indicates whether a Medicare beneficiary receives at least one high-risk drug, such as some antihistamines and muscle relaxants, that should be avoided in the elderly. The other assesses whether Medicare beneficiaries who have dementia, chronic kidney failure, or a history of pelvic or hip fractures are given prescriptions in the outpatient setting for drugs that shouldn't be given to patients with those conditions.
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