The Medicare Current Beneficiary-Survey (MCBS) is a powerful tool for analyzing enrollees' access to medical care (Adler, 1994). Based on a stratified random sample, we can derive information about the health care use, expenditure, and financing of Medicare's 36 million enrollees. We can also learn about those enrollees' health status, living arrangements, and access to and satisfaction with care.
In the charts that follow, we have presented some findings on variations in the use of prescribed medicines by Medicare fee-for-service (FFS) and health maintenance organization (HMO) enrollees.
Prescription Drug Use Rates in FFS and HMOs.
HMO and FFS beneficiaries have roughly the same user rates.
Out-of-Pocket Prescription Drug Expenditures for FFS and HMO Enrollees.
HMO enrollees pay slightly more than one-half that of their FFS counterparts on out-of-pocket prescription drug expenditures.
Generic Versus Brand-Name Drug Usage Among FFS and HMO Beneficiaries.
| Drug | FFS Mentions | Drug | HMO Mentions |
|---|---|---|---|
| Lanoxin | 11,040,029 | FUROSEMIDE | 765,020 |
| Cardizem | 7,279,562 | Lanoxin | 738,471 |
| Procardia | 6,848,458 | Vasotec | 580,145 |
| Zantac | 6,775,104 | Cardizem | 545,495 |
| FUROSEMIDE | 6,190,546 | HCTZ** | 496,224 |
| Lasix | 6,000,161 | Procardia | 479,228 |
| Vasotec | 5,992,800 | Premarin | 413,688 |
| Synthroid | 5,697,207 | Synthroid | 402,307 |
| Capoten | 5,500,437 | ISOSORBIDE DN | 401,875 |
| Premarin | 5,131,864 | Ventolin | 386,878 |
NOTES: HCTZ is Hydrochlorothiazide. Includes all beneficiaries who did not receive care from both FFS and Medicare HMOs during the year. Dual eligibles and those in institutions have been excluded from the analysis. Numbers may not add to totals due to rounding. Figures do not account for non-respondents. Drug names in capitals indicate generic. One mention equates to one container of a given medication. Does not include any drugs classified as “untranslatable” due to unrecognizable spellings.
SOURCE: Health Care Financing Administration, Office of the Actuary: Medicare Current Beneficiary Survey.
Of the top ten prescribed medications within FFS and HMO, FFS beneficiaries reported only one generic medicine, while their HMO counterparts reported three generics, including the most frequently cited drug.
The top ten FFS drugs represent 17.2 percent of all FFS mentions and 17.9 percent of FFS drug expenditures. The top ten HMO drugs represent 19.9 percent of all mentions and 17.3 percent of expenditures.
Footnotes
The authors are with the Office of the Actuary, Health Care Financing Administration. The opinions expressed are those of the authors and do not necessarily reflect those of the Health Care Financing Administration.
Reprint Requests: John A Poisal, Health Care Financing Administration, Office of the Actuary, 7500 Security Boulevard, N-3-03-13, Baltimore, Maryland 21244-1850.
Reference
- Adler G. A Profile of the Medicare Current Beneficiary Survey. Health Care Financing Review. 1994 Summer;15(4):153–163. [PMC free article] [PubMed] [Google Scholar]