Estimated Impact of Medicare Part D Senior Savings Model on Insulin User Spending on Medicare


New study presented at the 81st Scientific Session of the American Diabetes Association (ADA 2021) Details the Anticipated Impact of Medicare Part D’s Senior Savings Model (SMM) on Diabetes-Related Health Spending and Economic Outcomes in patients using insulin covered by Medicare.

With drug costs rising at the center of ADA 2021, study conducted by the University of Florida College of Pharmacy suggests Medicare Part D SSM would provide relief to more than 1.2 million people. insulin users and also indicates that the use of the savings model could reduce the risk of complications in this patient population.

With a general interest in the cost-effectiveness of diabetes treatments, Hui Shao, MD, PhD, assistant professor at the University of Florida College of Pharmacy, designed several studies presented at ADA 2021 designed to explore how the cost of diabetes management has changed. in recent years, including a study evaluating the cost-effectiveness of newer hypoglycemic agents compared to older agents. The present study was designed to assess the impact of SSM Medicare Part D on clinical and economic outcomes in Medicare insulin users.

To do this, the researchers designed their study to use data from the 2015-2016 iteration of the National Health and Nutrition Examination Survey (NHANES) and enter this information into the diabetes microsimulation model Building, Relating, Validating, Assessing. Outcomes (BRAVO) with the specific objective of simulating the impact of the savings model on diabetes complications, quality-adjusted life years (WALY) and medical costs.

Investigator analysis results suggest that 1.29 million Medicare-covered insulin users should be eligible for Medicare Part D SSM in 2021. Model results suggest that the SSM insulin policy was associated with relative risk reductions of 5.61% for stroke, 3.27% for angina, 3.79% for MACE and 3.49% for cardiovascular mortality at 5 years.

Over 5 years, the simulation model suggested that the SSM is expected to increase by $ 2.0 billion in medical costs, which equates to $ 1,573 per person, with a gain of 7,750 QALY added (ICER: $ 157,300 per QALY ). Over 20 years, the simulation model suggested that SSM Medicare Part D was associated with an additional $ 0.5 billion in medical costs with an increase in QALYs of 72,095 (ICER: $ 57,900 per QALY). Based on these calculations, the researchers suggest that the policy should be in place for more than 5 years to reduce costs among this patient population.

To learn more about this study and the potential impact of SSM Medicare Part D on Medicare patients using insulin, Endocrinology network contacted Shao and that conversation is the subject of this ADA 2021 home visit.

This study, “Medicare Part D Senior Savings Model (SSM) Projected Impact on Diabetes Health and Economic Outcomes Among Medicare-Covered Insulin Users, ”Was presented at ADA 2021.

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