Exhibit 4. Within Group Percentage of Non-Compliant Part D Recipients1 for Select Cardiovascular Agents by Therapeutic Class for Enrollees Age 65 & Over2, 2007.
| THERAPEUTIC CLASS | ||||||||
|---|---|---|---|---|---|---|---|---|
|
| ||||||||
| Antianginals | Antihyper-tensives | Antiar-rhythmics | Antihyper-lipidemics | Beta Blockers | Calcium Blockers | Cardiotonics | Diuretics | |
|
| ||||||||
| Class Percentage | 16.5 | 12.5 | 18.3 | 17.4 | 14.6 | 10.2 | 11.3 | 16.8 |
| Characteristic | ||||||||
| Region | ||||||||
| Midwest | 16.1 | 11.0 | 16.9 | 16.4 | 13.2 | 8.8 | 10.2 | 15.4 |
| Northeast | 14.5 | 11.3 | 16.5 | 15.9 | 13.4 | 9.4 | 10.5 | 16.0 |
| South | 18.0 | 14.2 | 19.8 | 19.9 | 16.8 | 11.7 | 12.3 | 19.5 |
| West | 15.4 | 11.2 | 17.9 | 14.6 | 13.3 | 9.2 | 10.5 | 14.1 |
| Other | 25.8 | 27.8 | 23.3 | 38.5 | 27.9 | 22.8 | 22.8 | 29.6 |
| Gender | ||||||||
| Female | 14.7 | 11.5 | 15.9 | 16.9 | 12.8 | 9.4 | 10.1 | 16.0 |
| Male | 18.9 | 14.1 | 20.9 | 18.4 | 17.7 | 11.9 | 13.0 | 18.6 |
| Age Group | ||||||||
| 65-74 | 18.4 | 13.7 | 18.9 | 18.7 | 16.0 | 11.6 | 11.8 | 17.5 |
| 75-84 | 16.2 | 11.9 | 18.1 | 16.6 | 14.0 | 9.7 | 11.2 | 16.6 |
| 85+ | 13.8 | 10.2 | 17.2 | 14.1 | 12.3 | 8.2 | 10.8 | 15.6 |
| Racial/Ethnic Origin | ||||||||
| Black | 21.8 | 18.4 | 23.2 | 24.8 | 21.9 | 16.9 | 17.0 | 22.8 |
| Hispanic | 17.8 | 15.8 | 17.5 | 21.4 | 16.6 | 13.3 | 12.1 | 17.4 |
| Other | 12.9 | 10.0 | 13.2 | 12.8 | 11.1 | 8.2 | 8.8 | 11.9 |
| White | 16.2 | 11.8 | 18.2 | 16.9 | 14.1 | 9.1 | 11.0 | 16.2 |
| Disease Burden3 | ||||||||
| Highest | 17.2 | 12.8 | 19.9 | 16.1 | 16.2 | 10.6 | 13.2 | 18.7 |
| Medium High | 16.8 | 12.4 | 19.1 | 17.1 | 14.7 | 10.0 | 11.5 | 17.3 |
| Medium Low | 16.5 | 12.3 | 18.0 | 17.6 | 13.9 | 9.9 | 10.6 | 16.1 |
| Lowest | 15.6 | 12.6 | 16.0 | 19.0 | 13.9 | 10.4 | 9.9 | 15.3 |
| Dual Status | ||||||||
| Dual4 | 16.4 | 10.9 | 14.6 | 14.0 | 12.5 | 9.7 | 9.6 | 15.6 |
| Non Dual4 | 16.6 | 13.0 | 19.1 | 18.3 | 15.2 | 10.4 | 11.7 | 17.2 |
| PDP Status | ||||||||
| MAPD4 | 17.0 | 13.6 | 18.7 | 18.5 | 15.5 | 11.2 | 11.9 | 16.8 |
| PDP4 | 16.4 | 12.1 | 18.1 | 17.0 | 14.3 | 9.8 | 11.1 | 16.8 |
| Relative OOP | ||||||||
| Non-Class Costs5 | ||||||||
| Highest | 16.0 | 10.3 | 17.5 | 14.4 | 12.9 | 8.1 | 10.6 | 16.4 |
| Medium High | 15.9 | 11.9 | 18.2 | 17.5 | 14.0 | 9.4 | 10.6 | 16.4 |
| Medium Low | 16.6 | 13.5 | 18.7 | 18.7 | 15.4 | 10.9 | 11.4 | 16.9 |
| Lowest | 17.7 | 14.4 | 18.6 | 19.1 | 16.3 | 12.6 | 12.6 | 17.5 |
| Relative OOP Daily | ||||||||
| Class Costs6 | ||||||||
| Highest | 19.3 | 15.3 | 18.9 | 18.6 | 17.2 | 12.5 | 13.3 | 18.9 |
| Medium High | 16.9 | 11.7 | 18.7 | 20.6 | 15.5 | 10.3 | 12.0 | 19.6 |
| Medium Low | 14.8 | 12.3 | 18.8 | 15.3 | 13.4 | 8.4 | 9.2 | 14.5 |
| Lowest | 15.0 | 10.7 | 16.6 | 15.2 | 12.3 | 9.3 | 10.3 | 14.7 |
A Part D recipient is a Medicare beneficiary enrolled for the entire 12 months in a Medicare Part D program and received at least one medication in 2007. Non-compliance based on within-group percentage (e.g., percentage of non-compliant female recipients to all female recipients).
Medications identified using the Medi-Span database. Medi-Span is a product of Wolters Kluwer Health. See http://www.wkhealth.com for details.
Disease burden based on hierarchical condition category risk scores acquired from the Centers for Medicare & Medicaid Services. Derivation based on quartiles.
Beneficiaries enrolled for the entire twelve months as this classification for calendar year 2007.
Relative Out-of-Pocket (OOP) Non-Class costs. Derivation based on quartiles. Quartile assignment made by (a)assigning the enrollee into one of the two groups of duals or non duals and (b) comparing the enrollee's OOP costs for all medications outside (i.e., external to) the class under study to other enrollees in the same assigned group.
Relative Out-of-Pocket (OOP) Daily Class costs. Derivation based on quartiles. Quartile assignment made by (a)assigning the enrollee into one of the two groups of duals or non duals and (b) comparing the enrollee's daily OOP costs for medications within the class under study to other enrollees in the same assigned group.