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Journal Article


Prescription Coverage, Use and Spending Before and After Part D Implementation: A National Longitudinal Panel Study

The Issue

Starting in 2006, 43 million Medicare beneficiaries became eligible for prescription drug coverage through Medicare Part D. Using administrative and survey data, the authors of this Commonwealth Fund–supported study evaluated subsequent changes in prescription drug coverage, use, and spending.

What the Study Found

The researchers reported three major findings:

  • In its initial year, the Part D program achieved many of its goals. In 2003, about one-quarter of seniors reported having no prescription drug coverage; by the end of 2006, nearly 90 percent of all beneficiaries had coverage, either through Part D or another source.
  • Beneficiaries who had employer-sponsored prescription coverage in 2003 experienced increased cost-sharing over the 2003–06 period, regardless of whether they retained that coverage or transitioned to Part D. This finding, the authors say, signifies a continued erosion of retiree health benefits.
  • Two distinct groups remained without prescription coverage throughout the three-year study period: 1) seniors who made a decision not to purchase coverage because of their good health status and low use of care, and 2) financially strained low-income seniors, many with chronic illness.


In its first year, Medicare Part D coverage "appears to have moderated prescription spending and cost-related burden for those who previously had meager benefits or none." The majority of low-income, chronically ill seniors who still lacked prescription coverage were unaware of the low-income assistance available for Part D premiums, underscoring the importance of aggressive, targeted outreach, the authors say.

Publication Details



D. G. Safran, M. K. Strollo, S. Guterman et al., "Prescription Coverage, Use and Spending Before and After Part D Implementation: A National Longitudinal Panel Study," Journal of General Internal Medicine, Jan. 2010 25(1):10–17.