Chartpack
Medicare Prescription Drug Benefit Progress Report:
Findings from the Kaiser/Commonwealth/Tufts-New England Medical
Center 2006 National Survey of Seniors and Prescription Drugs
August 2007
Methodology
The National Survey of Seniors and Prescription Drugs, 2006 was designed and analyzed by
researchers at the Kaiser Family Foundation, The Commonwealth Fund, and Tufts–New
England Medical Center. The survey of 16,072 seniors was administered in English and
Spanish between October 5 and December 20, 2006, primarily by mail with telephone followup. The study used an augmented longitudinal design that included respondents to our 2003
national survey of seniors and a randomly selected nationally representative sample of noninstitutionalized Medicare beneficiaries age 65 and older that was provided by the Centers for
Medicare and Medicaid Services in June 2006. After accounting for beneficiaries excluded
because of death, institutionalization, relocation, non-English/Spanish language, or severe
cognitive or physical impairment, the final study sample had a response rate of 56 percent.
The survey had a margin of sampling error of less than 1 percent. Bivariate and multivariate
methods were used to examine seniors’ prescription drug coverage, use, out-of-pocket
spending, adherence, and experiences in a Part D plan.
Prescription Drug Coverage of
Non-Institutionalized Seniors
Chart 1
Share of Non-Institutionalized Seniors Who Said They
Were Without Drug Coverage in 2005 and 2006
33%
8%
2005
2006
NOTES: Numbers are rounded.
SOURCE: Kaiser/Commonwealth/Tufts-New England Medical Center National Survey of Seniors and Prescription Drugs, 2006.
Chart 2
Distribution of Non-Institutionalized Seniors’ Drug Coverage in 2006
Among Those Who Did Not Have Drug Coverage in 2005
Drug coverage in 2005:
Source of Drug Coverage in 2006:
5%
7%
7%
Yes
67%
VA
Employer
Other
20%
No Rx Coverage
61%
Part D
No
33%
NOTES: VA is Department of Veterans Affairs. Numbers are rounded.
SOURCE: Kaiser/Commonwealth/Tufts-New England Medical Center National Survey of Seniors and Prescription Drugs, 2006.
Chart 3
Distribution of Non-Institutionalized Seniors by
Primary Source of Drug Coverage, 2006
Employer
Part D
31%
50%
3%
None
8%
7%
VA
Other
Coverage
NOTES: VA is Department of Veterans Affairs. Numbers are rounded.
SOURCE: Kaiser/Commonwealth/Tufts-New England Medical Center National Survey of Seniors and Prescription Drugs, 2006.
Chart 4
Part D Coverage Rates Among Seniors with Selected
Characteristics, 2006
Total
50%
Race/Ethnicity
White
African American
48%
62%*
Hispanic
66%*
% Poverty
<100%
101-150%
74%*
63%*
54%*
151-200%
>200%
40%
Chronic Conditions
None
1 or 2
3 or more
41%
50%*
54%*
NOTES: Weighted percentages. In 2006, federal poverty level: $9,800/individual and $13,200/couple. Reference groups for statistical
significance include: white, >200% poverty, and no chronic conditions (*p < 0.05). Numbers are rounded.
SOURCE: Kaiser/Commonwealth/Tufts-New England Medical Center National Survey of Seniors and Prescription Drugs, 2006.
Chart 5
Lack of Any Drug Coverage Among Seniors with Selected
Characteristics, 2006
Total
8%
Urban/Rural Location
10% *
Rural
Urban
8%
Race/Ethnicity
White
African American
8%
12% *
Hispanic
10%
% Poverty
14%*
<100%
101-150%
11%*
8%
151-200%
7%
>200%
Chronic Conditions
None
1 or 2
3 or more
23%
7%*
5% *
NOTES: Weighted percentages. In 2006, federal poverty level: $9,800/individual and $13,200/couple. Reference groups for statistical
significance include: white, >200% poverty, and no chronic conditions (*p < 0.05). Numbers are rounded.
SOURCE: Kaiser/Commonwealth/Tufts-New England Medical Center National Survey of Seniors and Prescription Drugs, 2006.
Chart 6
Seniors’ Drug Coverage in Selected States, 2006
49%
50%
44%*
46%*
52%
50%
63%*
34%
31%
35%*
36%*
21%*
3%
3%
7%
2%*
4%*
8%
10%
4%
5%*
7%
Total
CA
FL
23%*
57%*
Part D
Employer
VA
Other
No Rx Coverage
33%
24%*
4%
13%*
2%
8%
11%*
3%
6%*
4%
8%
6%*
8%
10%
9%
8%
NY
OH
PA
TX
7 State
Rural
Region
NOTES: VA is Department of Veterans Affairs. Seven state rural region includes: IA, MN, MT, ND, NE, SD, WY. Reference group for
statistical significance is Total (*p<0.05). Numbers are rounded.
SOURCE: Kaiser/Commonwealth/Tufts-New England Medical Center National Survey of Seniors and Prescription Drugs, 2006.
Chart 7
Low-Income Seniors’ Drug Coverage in Selected States, 2006
68%
77%*
10%
2%
8%
4%*
2%
3%*
12%
15%
Total
CA
71%
66%
10%
10%
1%
3%
6%
16%*
11%
7%*
FL
NY
57%*
58%*
68%
21%*
2%
9%
12%
OH
74%*
10%
3%
13%*
12%
2%
6%
6%
2%
7%
16%
13%
10%
PA
TX
7 State
Rural
Region
Part D
Employer
VA
Other
No Rx Coverage
NOTES: VA is Department of Veterans Affairs. Seven state rural region includes: IA, MN, MT, ND, NE, SD, WY. Low-income refers to
seniors at or below 150% of poverty. Reference group for statistical significance is Total (*p<0.05). Numbers are rounded.
SOURCE: Kaiser/Commonwealth/Tufts-New England Medical Center National Survey of Seniors and Prescription Drugs, 2006.
Characteristics of NonInstitutionalized Seniors with
Various Sources of Drug Coverage
Chart 8
Income Distribution of Non-Institutionalized Seniors, by
Source of Drug Coverage, 2006
45%
46%
57%
>200% FPL
82%*
9%
11%
<100% FPL
18%*
23%
21%
Part D
150-200% FPL
101-150% FPL
17%*
9%*
8%*
Employer
23%
23%
2%*
8%*
VA
None
NOTES: VA is Department of Veterans Affairs. "Other coverage" is not shown. In 2006, federal poverty level (FPL): $9,800/individual
and $13,200/couple. The reference group for statistical significance is Part D coverage (*p < 0.05). Numbers are rounded.
SOURCE: Kaiser/Commonwealth/Tufts-New England Medical Center National Survey of Seniors and Prescription Drugs, 2006.
Chart 9
Race/Ethnicity of Non-Institutionalized Seniors, by Source
of Drug Coverage, 2006
83%
81%
90%*
White
95%*
African American
Hispanic
Asian/Other
8%
8%
4%*
6%
3%*
3%*
6%
3%
3%
2%*
1%
5%
Part D
Employer
VA
None
NOTES: VA is Department of Veterans Affairs. "Other coverage" is not shown. Reference group for statistical significance is Part D
Coverage (*p < 0.05). Numbers are rounded.
SOURCE: Kaiser/Commonwealth/Tufts-New England Medical Center National Survey of Seniors and Prescription Drugs, 2006.
Chart 10
Rural/Urban Residence of Non-Institutionalized Seniors, by
Source of Drug Coverage, 2006
76%
68%*
79%*
71%*
Urban
Rural
24%
21%*
Part D
Employer
33%*
29%
VA
None
NOTES: VA is Department of Veterans Affairs. "Other coverage" is not shown. Reference group for statistical significance is Part D
coverage (*p < 0.05). Numbers are rounded.
SOURCE: Kaiser/Commonwealth/Tufts-New England Medical Center National Survey of Seniors and Prescription Drugs, 2006.
Chart 11
Number of Prescriptions Taken Monthly by NonInstitutionalized Seniors, by Source of Drug Coverage, 2006
12%*
25%
25%
31%*
32%*
45%
45%
48%
26%*
14%
30%*
21%
21%
9%
10%
7%
Part D
Employer
VA
7 or more
3 to 6
1 or 2
None
None
NOTES: VA is Department of Veterans Affairs. "Other coverage" is not shown. Reference group for statistical significance is Part D
coverage (*p < 0.05). Numbers are rounded.
SOURCE: Kaiser/Commonwealth/Tufts-New England Medical Center National Survey of Seniors and Prescription Drugs, 2006.
Prescription Drug Use, Out-of-Pocket
Spending, and Non-Adherence
Chart 12
Mean Number of Prescriptions Filled by Seniors Per Month,
by Source of Drug Coverage, 2006
(Among Seniors Taking 1 or More Rx)
Total
No Rx Coverage
Part D
Employer
VA
Other
6.3
6.5
6.5
6.3
5.6*
5.0
4.9
5.0
5.6*
5.8*
4.7*
4.0*
All Seniors
Seniors with 3+ Chronic
Conditions
NOTES: VA is Department of Veterans Affairs. Reference group for statistical significance is Part D coverage (*p<0.05). Numbers are
rounded.
SOURCE: Kaiser/Commonwealth/Tufts-New England Medical Center National Survey of Seniors and Prescription Drugs, 2006.
Chart 13
Share of Seniors Spending More Than $300 Per Month on
Prescriptions, by Source of Drug Coverage, 2006
(Among Seniors Taking 1 or More Rx)
Total
No Rx Coverage
Part D
Employer
VA
Other
14%
11%*
7%
10%
8%
8%
11%
11%
8%*
7%*
5%* 5%*
All Seniors
Seniors with 3+ Chronic
Conditions
NOTES: VA is Department of Veterans Affairs. Reference group for statistical significance is Part D coverage (*p<0.05). Numbers are
rounded.
SOURCE: Kaiser/Commonwealth/Tufts-New England Medical Center National Survey of Seniors and Prescription Drugs, 2006.
Chart 14
Share of Seniors Who Did Not Fill or Delayed Filling
Prescriptions Due to Cost, by Source of Drug Coverage, 2006
(Among Seniors Taking 1 or More Rx)
Total
No Rx Coverage
Part D
Employer
VA
Other
35%*
25%
23%*
21%
20%
16%
15%*
12%*
16%*
18%*
12%*
8%*
All Seniors
Seniors with 3+ Chronic
Conditions
NOTES: “Did not fill/delayed fill of Rx” refers to not filling or delay filling or refilling a prescription because of cost in the past twelve
months. VA is Department of Veterans Affairs. Reference group for statistical significance is Part D coverage (*p<0.05). Numbers are
rounded.
SOURCE: Kaiser/Commonwealth/Tufts-New England Medical Center National Survey of Seniors and Prescription Drugs, 2006.
Chart 15
Multivariate Results Showing Association Between Sources of Drug
Coverage, Out-of-Pocket Spending, and Non-Adherence, 2006
(Odds Ratios)
Spend >$100/month
Spend >$300/month
3.3
2.3
Did not fill/Delay fill
or refill due to cost in
past 12 months
2.3
1.8
2.2
2.0
1.7
1.6
1.4
Source of
Coverage
vs.
Reference
Group
None
Part D
Part D
None
vs.
vs.
vs.
vs.
Part D
Employer
VA
Part D
Part D
Part D
None
vs.
vs.
VA
Part D
vs.
Employer
Part D
Part D
vs.
Employer
vs.
VA
Notes: Findings based on three separate models each of which controlled for demographics, health measures, self-reported diseases, number of duals, and
source of coverage. Among seniors taking one or more prescription medications. VA is Department of Veterans Affairs. Numbers are rounded.
SOURCE: Kaiser/Commonwealth/Tufts-New England Medical Center National Survey of Seniors and Prescription Dugs, 2006.
Chart 16
Share of Seniors Who Purchased Prescriptions From
Canada or Mexico, by Source of Drug Coverage, 2006
(Among Seniors Taking 1 or More Rx)
Total
4%
Part D
Employer
VA
Other
No Rx
Coverage
5%
2%*
5%
4%
10%*
NOTES: VA is Department of Veterans Affairs. Reference group for statistical significance is Part D coverage (*p<0.05). Numbers are
rounded.
SOURCE: Kaiser/Commonwealth/Tufts-New England Medical Center National Survey of Seniors and Prescription Drugs, 2006.
Characteristics and Cost-Related
Experiences of Non-Institutionalized
Seniors in Part D Plans
Chart 17
Part D Enrollment Among Non-Institutionalized Seniors, by
Plan Type, 2006
Medicare
Advantage
Prescription
Drug Plan
(MAPD)
30%
Stand-Alone
Prescription
Drug Plan
(PDP)
70%
NOTES: Numbers are rounded.
SOURCE: Kaiser/Commonwealth/Tufts-New England Medical Center National Survey of Seniors and Prescription Drugs, 2006.
Chart 18
Share of Seniors in Part D Plans (PDP vs. MAPD) with
Selected Characteristics, 2006
Age 85+
12%*
10%
≤100%
Poverty
Rural
location
7+ Rx
(per month)
3+ Chronic
Conditions
24%*
Stand-Alone
Prescription Drug Plan
(PDP)
Medicare Advantage
Prescription Drug Plan
(MAPD)
13%
31%*
7%
30%*
23%
45%*
37%
NOTES: Weighted percentages. Significance testing: PDP versus MAPD plan (*p<0.05). In 2006, federal poverty level:
$9,800/individual and $13,200/couple. Numbers are rounded.
SOURCE: Kaiser/Commonwealth/Tufts-New England Medical Center National Survey of Seniors and Prescription Drugs, 2006.
Chart 19
Race/Ethnicity of Seniors in Part D Plans, by Part D
Plan Type, 2006
6%
8%
5%*
8%
8%
7%
Nonwhite Hispanic
African American
White
83%
83%
82%
Total
Stand-Alone
Prescription Drug
Plan (PDP)
Medicare Advantage
Prescription Drug
Plan (MAPD)
NOTES: Weighted percentages. Significance testing: PDP versus MAPD plan (*p<0.05). Numbers are rounded.
SOURCE: Kaiser/Commonwealth/Tufts-New England Medical Center National Survey of Seniors and Prescription Drugs, 2006.
Chart 20
Prescription Out-of-Pocket Spending and Non-Adherence
Among Seniors in Part D Plans, by Part D Plan Type, 2006
(Among Seniors Taking 1 or More Rx)
28%*
Stand-Alone
Prescription Drug
Plan (PDP)
22%
21%*
17%
8%*
Did Not
Fill/Delayed Filling
Due to Cost
Spent
>$100/month
7%
Medicare
Advantage
Prescription Drug
Plan (MAPD)
Spent
>$300/month
NOTES: Weighted percentages. Significance testing: PDP versus MAPD plan (*p<0.05). Numbers are rounded.
SOURCE: Kaiser/Commonwealth/Tufts-New England Medical Center National Survey of Seniors and Prescription Drugs, 2006.
Role of the Part D Low-Income Subsidy
(LIS) and Non-Institutionalized Seniors’
Related Experiences
Chart 21
Drug Coverage Among Seniors with Incomes At or Below
150% of Poverty Who Were Not Receiving the LowIncome Subsidy (LIS), 2006
No Rx
Coverage
16%
Other
Part D
14%
48%
Employer/
VA
23%
NOTES: VA is Department of Veterans Affairs. Numbers are rounded.
SOURCE: Kaiser/Commonwealth/Tufts-New England Medical Center National Survey of Seniors and Prescription Drugs, 2006.
Chart 22
Characteristics of Seniors in Part D Plans, With Incomes
At or Below 150% of Poverty, With and Without the LowIncome Subsidy (LIS), 2006
Age 85+
18%
14%
78%
70%
Female
Rural Location
7+ Rx
(per month)
3+ Chronic
Conditions
With LIS
Without LIS
32%
28%
37%
26%
54%
42%
NOTES: Weighted percentages. Excludes dual eligibles and seniors for whom LIS status is unknown (n=686). Significance testing:
with LIS versus without LIS (*p<0.05). In 2006, federal poverty level: $9,800/individual and $13,200/couple. Numbers are rounded.
SOURCE: Kaiser/Commonwealth/Tufts-New England Medical Center National Survey of Seniors and Prescription Drugs, 2006.
Chart 23
Out-of-Pocket Spending on Prescriptions and Non-Adherence
Among Low-Income Seniors in Part D Plans, With and Without the
Low-Income Subsidy (LIS), 2006
(Among Seniors Taking 1 or More Rx)
With LIS
Without LIS
32%
27%
22%
11%*
9%
4%*
Did Not Fill/Delayed Spent >$100/month Spent >$300/month
Filling Due to Cost
NOTES: Weighted percentages. Excludes dual eligibles and seniors for whom LIS status is unknown (n=686). Significance testing:
with LIS versus without LIS (*p < 0.05). Low-income is defined as at or below 150% of poverty. In 2006, federal poverty level:
$9,800/individual and $13,200/couple. Numbers are rounded.
SOURCE: Kaiser/Commonwealth/Tufts-New England Medical Center National Survey of Seniors and Prescription Drugs, 2006.
Chart 24
Share of Seniors With Incomes At or Below 150% of Poverty Who Said
That They Were Not Aware of the Part D Low-Income Subsidy (LIS),
Among Those Not Receiving The LIS, 2006
Total
48%
% Poverty
≤100%
101% - 134%
135% - 150%
53%*
50%*
43%
Race/Ethnicity
White
African American
Hispanic
46%
65%*
65%*
NOTES: Weighted percentages. Reference Groups: 135-150% of poverty, white, and Part D Rx Coverage (*p<0.05). In 2006, federal
poverty level: $9,800/individual and $13,200/couple. Numbers are rounded.
SOURCE: Kaiser/Commonwealth/Tufts-New England Medical Center National Survey of Seniors and Prescription Drugs, 2006.
Cost-Related Experiences of NonInstitutionalized Seniors in Part D
Plans, by Income and Low-Income
Subsidy (LIS) Status
Chart 25
Seniors in Part D Plans Who Spent More Than $100 Per
Month on Prescriptions, by Income Level and Low-Income
Subsidy (LIS) Status, 2006
(Among Seniors Taking 1 or More Rx)
32%
35%
33%
26%
11%*
7%*
Total Part
Dual
D
Eligibles
<150%
Poverty
With LIS
<150%
Poverty
Without
LIS
151200%
Poverty
>200%
Poverty
NOTES: Weighted percentages. Excludes seniors for whom LIS status is unknown (n=686). Significance testing: >200% poverty as
reference group, except as indicated (*p < 0.05). In 2006, federal poverty level: $9,800/individual and $13,200/couple. Numbers
are rounded.
SOURCE: Kaiser/Commonwealth/Tufts-New England Medical Center National Survey of Seniors and Prescription Drugs, 2006.
Chart 26
Seniors in Part D Plans Who Spent More Than $300 Per
Month on Prescriptions, by Income Level and Low-Income
Subsidy (LIS) Status, 2006
(Among Seniors Taking 1 or More Rx)
11%
10%
9%
8%
4%*
2%*
Total Part
Dual
D
Eligibles
<150%
Poverty
With LIS
<150%
Poverty
Without
LIS
151200%
Poverty
>200%
Poverty
NOTES: Weighted percentages. Excludes seniors for whom LIS status is unknown (n=686). Significance testing: >200% poverty as
reference group, except as indicated (*p < 0.05). In 2006, federal poverty level: $9,800/individual and $13,200/couple. Numbers
are rounded.
SOURCE: Kaiser/Commonwealth/Tufts-New England Medical Center National Survey of Seniors and Prescription Drugs, 2006.
Chart 27
Seniors in Part D Plans Who Did Not Fill or Delayed Filling a
Prescription Due to Costs in the Past Twelve Months, by
Income Level and Low-Income Subsidy (LIS) Status, 2006
(Among Seniors Taking 1 or More Rx)
27%*
20%
20%*
26%*
22%*
15%
Total Part
Dual
D
Eligibles
<150%
Poverty
With LIS
<150%
Poverty
Without
LIS
151200%
Poverty
>200%
Poverty
NOTE: Weighted percentages. Excludes seniors for whom LIS status is unknown (n=686). Significance testing: >200% poverty as
reference group (*p < 0.05). In 2006, federal poverty level: $9,800/individual and $13,200/couple. Numbers are rounded.
SOURCE: Kaiser/Commonwealth/Tufts-New England Medical Center National Survey of Seniors and Prescription Drugs, 2006.
Chart 28
Part D Enrollees’ Experiences Since Enrolling in a Part D Plan,
by Income Level and Low-Income Subsidy (LIS) Status, 2006
(Among Seniors Taking 1 or More Rx)
Total
Dual Eligibles
≤150% FPL w/ LIS
≤150% FPL w/out LIS
151-200% FPL
>200% FPL
20%*
11%*
8%
8% 8% 8%
11%
6%
Changed Part D Plans
13%
7%
10%
8%
Needed Permission to Fill Rx
NOTE: Weighted percentages. Excludes seniors for whom LIS status is unknown (n=686). Significance testing: >200% poverty as
reference group (*p < 0.05). In 2006, federal poverty level (FPL): $9,800/individual and $13,200/couple. Numbers are rounded.
SOURCE: Kaiser/Commonwealth/Tufts-New England Medical Center National Survey of Seniors and Prescription Drugs, 2006.
Chart 29
Share of Part D Enrollees’ Who Started Ordering
Prescriptions by Mail, by Income Level and Low-Income
Subsidy (LIS) Status, 2006
(Among Seniors Taking 1 or More Rx)
15%
21%
15%*
13%*
9%*
6%*
Total Part D
Dual
Eligibles
<150%
Poverty
with LIS
<150%
151-200%
Poverty
Poverty
without LIS
>200%
Poverty
NOTE: Weighted percentages. Excludes seniors for whom LIS status is unknown (n=686). Significance testing: >200% poverty as
reference group (*p < 0.05). In 2006, federal poverty level: $9,800/individual and $13,200/couple. Numbers are rounded.
SOURCE: Kaiser/Commonwealth/Tufts-New England Medical Center National Survey of Seniors and Prescription Drugs, 2006.