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Black Seniors Twice as Likely as Whites to Go Without Prescriptions Because of Cost
Study Shows Comprehensive Medicare Drug Benefit for Low-Income Seniors Could Narrow Disparities
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ASHINGTON, D.C.— Elderly African-American Medicare beneficiaries are more than twice as likely as whites to report they cant afford prescription medications, according to a national study released today by the Center for Studying Health System Change (HSC).
Almost one in six black Medicare beneficiaries 65 and older did not fill at least one prescription in the last year because of cost, compared with one in 15 whites. African Americans lower incomes, lack of supplemental insurance and greater prevalence of certain chronic conditions, such as heart disease, high blood pressure and diabetes, all contribute to the prescription drug access gap between older black and white Americans.
"Theres no question that the lack of Medicare prescription drug coverage falls disproportionately on African-American seniors," said Paul B. Ginsburg, Ph.D., president of HSC, a nonpartisan policy research organization funded exclusively by The Robert Wood Johnson Foundation.
"Prescription drugs are an essential aspect of modern medicine, and this study shows many black seniors are going without needed prescription medications," said HSC Health Research Analyst Marie Reed, M.H.S., who co-authored the study with HSC Senior Researcher J. Lee Hargraves, Ph.D.
Both chambers of Congress recently passed legislation to provide prescription drug coverage to Medicare beneficiaries. While details of the House and Senate proposals differ significantly, both provide targeted assistance to some low-income beneficiaries through premium subsidies and reduced cost sharing. Either proposal could help reduce racial disparities in access to prescription drugs among the poorest beneficiaries, but both proposals would leave many low-income beneficiaries—particularly those with incomes above 135 percent of poverty but below 200 percent of poverty—with substantial out-of-pockets costs if they need ongoing or expensive drug therapies.
"As Congress debates how to structure a Medicare drug benefit, this study shows that designing a comprehensive benefit with minimal out-of-pocket costs for all low-income seniors could significantly reduce racial disparities in access to prescription drugs for older Americans," Ginsburg said
The studys findings are detailed in a new HSC Issue Brief—Unequal Access: African-American Medicare Beneficiaries and the Prescription Drug Gap. Based on results from HSCs Community Tracking Study 2001 Household Survey, a nationally representative survey involving about 60,000 people, the study includes responses from about 7,770 elderly Medicare beneficiaries, excluding those living in institutions such as nursing homes.
HSC researchers determined that almost half (46%) of the nearly 10-percentage-point gap in prescription drug access between black and white seniors is attributable to differences in income, supplemental insurance coverage and presence of chronic conditions. Another portion of the gap—nearly 20 percent—is explained by other factors such as gender, age, family size and education. The remaining access gap likely results from a variety of other influences. For example, people with savings or other assets do not need to rely exclusively on income to afford medications.
Stakeholder Comments on the HSC Study
Risa Lavizzo-Mourey, M.D., M.B.A., president and CEO, The Robert Wood Johnson
and minorities. Uncontrolled high blood pressure is the No. 1 health problem
in our community with one out of three African Americans affected and only one
out of five diagnosed hypertensives adequately treated. Unfortunately, it requires
more antihypertensives to lower blood pressure to safe levels for African Americans.
The fact that twice as many African Americans have difficulty filling their
prescriptions exacerbates the problem leading to too many African American children
growing up without the nurturing guidance of their grandparents."
The Center for Studying Health System Change is a nonpartisan policy research organization committed to providing objective and timely insights on the nations changing health system to help inform policy makers and contribute to better health care policy. HSC, based in Washington, D.C., is funded exclusively by The Robert Wood Johnson Foundation and is affiliated with Mathematica Policy Research, Inc.