Racial and ethnic disparities in meeting MTM eligibility criteria among patients with asthma

ABSTRACT

Background: Asthma is one of the most frequently targeted chronic diseases in the medication therapy management (MTM) programs of the Medicare prescription drug (Part D) benefits. Although racial and ethnic disparities in meeting eligibility criteria for MTM services have been reported, little is known about whether there would be similar disparities among adults with asthma in the United States. Methods: Adult patients with asthma (age ≥ 18) from Medical Expenditure Panel Survey (2011–2012) were analyzed. Bivariate analyses were conducted to compare the proportions of patients who would meet Medicare MTM eligibility criteria between non-Hispanic Blacks (Blacks), Hispanics and non-Hispanic Whites (Whites). Survey-weighted logistic regression was performed to adjust for patient characteristics. Main and sensitivity analyses were conducted to cover the entire range of the eligibility thresholds used by Part D plans in 2011–2012. Results: The sample included 4,455 patients with asthma, including 2,294 Whites, 1,218 Blacks, and 943 Hispanics. Blacks and Hispanics had lower proportions of meeting MTM eligibility criteria than did Whites (P < 0.001). According to the main analysis, Blacks and Hispanics had 36% and 32% lower, respectively, likelihood of MTM eligibility than Whites (odds ratio [OR]: 0.64, 95% confidence interval [CI]: 0.45–0.90; OR: 0.68, 95% CI: 0.47–0.98, respectively). Similar results were obtained in sensitivity analyses. Conclusions: There are racial and ethnic disparities in meeting Medicare Part D MTM eligibility criteria among adult patients with asthma. Future studies should examine the implications of such disparities on health outcomes of patients with asthma and explore alternative MTM eligibility criteria.

KEYWORDS:

• Asthma
• race
• ethnicity
• disparity
• medication therapy management services
• eligibility criteria

Declaration of interest

Dr. Wang previously has been funded by Pfizer Inc. and Bristol-Myers Squibb. The other authors have no conflict of interest. The funding agency was not involved in the conduct of the study. Dr. Lu takes responsibility for the integrity of the data and the accuracy of the data analysis. Dr. Lu, Ms. Qiao, and Dr. Wang participated in data acquisition, study design, data interpretation, and writing and revision of the manuscript. The authors alone are responsible for the content and writing of the article.

Funding

Research reported in this publication was supported by the National Institute On Aging of the National Institutes of Health under Award Number R01AG049696. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.