{"id":18489,"date":"2020-02-25T10:57:10","date_gmt":"2020-02-25T15:57:10","guid":{"rendered":"https:\/\/avalere.com\/?p=18489"},"modified":"2021-11-04T16:21:25","modified_gmt":"2021-11-04T20:21:25","slug":"patient-costs-among-medicare-part-d-users-of-mental-health-drugs","status":"publish","type":"post","link":"https:\/\/advisory.avalerehealth.com\/insights\/patient-costs-among-medicare-part-d-users-of-mental-health-drugs","title":{"rendered":"Patient Costs Among Medicare Part D Users of Mental Health Drugs"},"content":{"rendered":"<p>As medication affordability increasingly becomes a focal point for policy makers, out-of-pocket (OOP) spending is a growing point of pressure for vulnerable populations, including those with mental health disorders. Avalere examined the burden of OOP spending on non-low-income subsidy (non-LIS) Medicare Part D beneficiaries using <a href=\"https:\/\/advisory.avalerehealth.com\/insights\/medication-adherence-rates-low-among-patients-with-serious-mental-illness\">mental health medications<\/a>.<\/p>\n<p>Avalere analyzed patient progression through each phase of the <a href=\"https:\/\/advisory.avalerehealth.com\/insights\/cms-proposes-allowing-part-d-plans-to-implement-a-new-preferred-specialty-tier\">Part D<\/a> benefit. Among non-LIS beneficiaries taking mental health drugs of any kind during a year, 20% reached the coverage gap and 5% reached the catastrophic phase by the end of the year. Approximately half of those beneficiaries reached the coverage gap by mid-year and stayed there for an average of 4 months.<\/p>\n<p>Additionally, Avalere found that beneficiaries assumed financial liability for 46% of the cost of their mental health drugs and 23% of the cost of their non-mental health drugs. This translates to an average of $760 per beneficiary in annual total OOP spending for non-LIS beneficiaries using mental health medications.<\/p>\n<h2>Methodology<\/h2>\n<p>Avalere analyzed 2018 Part D prescription drug event data as well as Medi-Span&#8217;s Generic Product Identifier therapeutic classification system to identify the following drug classes within the mental health category: antidepressants, antipsychotics, anxiolytics, and mood stabilizers. Avalere limited the analysis sample not to exceed 20% of the overall Part D beneficiary population and examined OOP costs for non-LIS Part D users of mental health drugs enrolled in non-employer group waiver plans.<\/p>\n<p>To receive Avalere updates, <a href=\"https:\/\/info.avalere.com\/LP=46\">connect with us<\/a>.<\/p>\n<p>Find out the <a href=\"https:\/\/advisory.avalerehealth.com\/webinars\/avalere-2020-healthcare-industry-outlook-see-the-turns-ahead\">top 2020 healthcare trends to watch<\/a>.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>As medication affordability increasingly becomes a focal point for policy makers, out-of-pocket (OOP) spending is a growing point of pressure for vulnerable populations, including those with mental health disorders. Avalere examined the burden of OOP spending on non-low-income subsidy (non-LIS) Medicare Part D beneficiaries using mental health medications. Avalere analyzed patient progression through each phase&hellip;<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"footnotes":""},"categories":[3],"tags":[],"content-categories":[259],"class_list":["post-18489","post","type-post","status-publish","format-standard","hentry","category-insights","content-categories-policy","entry","no-media"],"acf":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v24.0 - https:\/\/yoast.com\/wordpress\/plugins\/seo\/ -->\n<title>Patient Costs Among Medicare Part D Users of Mental Health Drugs | Avalere Health Advisory<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/advisory.avalerehealth.com\/insights\/patient-costs-among-medicare-part-d-users-of-mental-health-drugs\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Patient Costs Among Medicare Part D Users of Mental Health Drugs | Avalere Health Advisory\" \/>\n<meta property=\"og:description\" content=\"As medication affordability increasingly becomes a focal point for policy makers, out-of-pocket (OOP) spending is a growing point of pressure for vulnerable populations, including those with mental health disorders. Avalere examined the burden of OOP spending on non-low-income subsidy (non-LIS) Medicare Part D beneficiaries using mental health medications. Avalere analyzed patient progression through each phase&hellip;\" \/>\n<meta property=\"og:url\" content=\"https:\/\/advisory.avalerehealth.com\/insights\/patient-costs-among-medicare-part-d-users-of-mental-health-drugs\" \/>\n<meta property=\"og:site_name\" content=\"Avalere Health Advisory\" \/>\n<meta property=\"article:published_time\" content=\"2020-02-25T15:57:10+00:00\" \/>\n<meta property=\"article:modified_time\" content=\"2021-11-04T20:21:25+00:00\" \/>\n<meta name=\"author\" content=\"avalere_wp\" \/>\n<meta name=\"twitter:card\" content=\"summary_large_image\" \/>\n<meta name=\"twitter:creator\" content=\"@avalerehealth\" \/>\n<meta name=\"twitter:site\" content=\"@avalerehealth\" \/>\n<meta name=\"twitter:label1\" content=\"Written by\" \/>\n\t<meta name=\"twitter:data1\" content=\"avalere_wp\" \/>\n\t<meta name=\"twitter:label2\" content=\"Est. reading time\" \/>\n\t<meta name=\"twitter:data2\" content=\"1 minute\" \/>\n<!-- \/ Yoast SEO plugin. -->","yoast_head_json":{"title":"Patient Costs Among Medicare Part D Users of Mental Health Drugs | Avalere Health Advisory","robots":{"index":"index","follow":"follow","max-snippet":"max-snippet:-1","max-image-preview":"max-image-preview:large","max-video-preview":"max-video-preview:-1"},"canonical":"https:\/\/advisory.avalerehealth.com\/insights\/patient-costs-among-medicare-part-d-users-of-mental-health-drugs","og_locale":"en_US","og_type":"article","og_title":"Patient Costs Among Medicare Part D Users of Mental Health Drugs | Avalere Health Advisory","og_description":"As medication affordability increasingly becomes a focal point for policy makers, out-of-pocket (OOP) spending is a growing point of pressure for vulnerable populations, including those with mental health disorders. Avalere examined the burden of OOP spending on non-low-income subsidy (non-LIS) Medicare Part D beneficiaries using mental health medications. 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