New Study Will Examine Effects of Excluding Anti-anxiety Medications in Medicare Part D Coverage

A new research grant funded by NIMH will examine the costs and benefits of excluding a commonly prescribed class of anti-anxiety medications—benzodiazepines—from coverage in the new Medicare Part D program. Medicare Part D, the prescription drug coverage plan for people insured by Medicare, went into effect in January 2006. The two-year grant will examine how this large public health initiative is affecting treatment of anxiety disorders in older adults.

The decision to exclude benzodiazepines from Medicare Part D coverage was based in part on clinical studies indicating that even though the medications are an effective treatment for anxiety disorders, older people who take them are at an increased risk for falls and hip fractures, and they may worsen conditions such as emphysema, urinary incontinence and depression. Susan Ettner, PhD, of the University of California, Los Angeles, and colleagues will examine how the exclusion is affecting patient care and the use and costs of health care services, including mental health services.

The researchers will use prescription drug, behavioral and medical claims of Medicare participants enrolled since 2004 to analyze their rates of hospital stays, emergency department visits, doctor's visits, and overall behavioral and medical costs. To assess the short-term effects of the exclusion, the researchers will examine participants who had been taking a benzodiazepine before Medicare Part D went into effect. To assess long-term implications of the exclusion, they will examine participants newly diagnosed with an anxiety-related disorder. These data will be compared with data on individuals whose benzodiazepine coverage was unaffected by the Medicare Part D program.

The researchers seek to understand not only how the change in coverage affects the health of patients, but also whether the change will result in health care savings or additional costs for the Part D program. The results will help to inform the ongoing policy debate about whether Medicare Part D needs to be amended to include coverage for benzodiazepines.