“Medicare Could Collect Billions If Pharmaceutical Manufacturers Were Required to Pay Rebates for Part B Drugs,” (OEI-12-12-00260, September 2013, .pdf format, 26p.).
September 11, 2013
CAAR – US Department of Health and Human Services, Office of Inspector General Report – September 11, 2013
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July 1, 2013
CAAR – National Bureau of Economic Research Working Papers – July 1, 2013
A. “Decision Complexity as a Barrier to Annuitization,” by Jeffrey R. Brown, Arie Kapteyn, Erzo F.P. Luttmer, and Olivia S. Mitchell (w19168, June 2013, .pdf format, 37p.).
Abstract:
We show that people have difficulty valuing annuities, and this, instead of a preference for lumpsums, helps explain observed low annuity demand. Although the median price at which people are willing to sell an annuity stream is close to the actuarial value, many responses diverge greatly from optimizing behavior. Moreover, people will pay substantially less to buy than to sell annuities. We conclude that boundedly rational consumers adopt “buy low, sell high” heuristics when confronting a complex trade-off. This suggests that many consumers do not make optimizing decisions, underscoring the difficulty of explaining cross-sectional annuity valuation differences using standard models.
B. “Evolving Choice Inconsistencies in Choice of Prescription Drug Insurance,” by Jason Abaluck and Jonathan Gruber (w19163, June 2013, .pdf format, 47p.).
Abstract:
We explore choice inconsistency over time within the Medicare Part D Prescription Drug Program. Using the full universe of Part D claims data, we revisit our earlier work on partial data to replicate our results showing large “foregone savings” among Part D enrollees. We also document that this foregone savings increases over time during the first four years of the Part D program. We then develop a rich dynamic structural framework that allows us to mathematically decompose the “foregone welfare” from inconsistent plan choices into components due to demand side factors, supply side factors, and changes in preferences over time. We find that the welfare cost of choice inconsistencies increases over time. Most importantly, we find that there is little improvement in the ability of consumers to choose plans over time; we identify and estimate little learning at either the individual or cohort level over the years of our analysis. Inertia does reduce welfare, but even in a world with no inertia we estimate that substantial welfare losses would remain. We conclude that the increased choice inconsistencies over time are driven by changes on the supply side that are not offset both because of inertia and because non-inertial consumers still make inconsistent choices.
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June 25, 2013
CAAR – AARP Report – June 25, 2013
“Rx Price Watch Case Study: Efforts to Reduce the Impact of Generic Competition for Lipitor,” by Leigh Purvis and Stephen W. Schondelmeyer (June 2013, .pdf format, 16p.).
www.aarp.org/health/drugs-supplements/info-08-2010/rx_price_watch.html
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June 3, 2013
CAAR – Medical Expenditure Panel Survey Statistical Brief – June 3, 2013
“Expenditures for the Top Five Therapeutic Classes of Outpatient Prescription Drugs, Medicare Beneficiaries, Age 65 and Older, U.S. Civilian Noninstitutionalized Population, 2010,” by Anita Soni and Marc Roemer (Statistical Brief No. 411, May 2013, .pdf and HTML format, 6p.).
meps.ahrq.gov/mepsweb/data_stats/Pub_ProdResults_Details.jsp?pt=Statistical+Brief&opt=2&id=1109
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May 30, 2013
CAAR – Public Library of Science (PLoS) Articles – May 30, 2013
A. “Linking Protective GAB2 Variants, Increased Cortical GAB2 Expression and Decreased Alzheimer’s Disease Pathology,” by Fanggeng Zou, Olivia Belbin, Minerva M. Carrasquillo, Oliver J. Culley, Talisha A. Hunter, Li Ma, Gina D. Bisceglio, Mariet Allen, Dennis W. Dickson, Neill R. Graff-Radford, Ronald C. Petersen, the Genetic and Environmental Risk for Alzheimer’s disease (GERAD1) Consortium, Kevin Morgan, and Steven G. Younkin (PLoS ONE 8(5): e64802. doi:10.1371/journal.pone.0064802, XML, HTML, and .pdf format, 11p.).
www.plosone.org/article/info%3Adoi%2F10.1371%2Fjournal.pone.0064802
B. “Comparison of Treatment Effect Estimates for Pharmacological Randomized Controlled Trials Enrolling Older Adults Only and Those including Adults: A Meta-Epidemiological Study,” by Valerie Seegers, Ludovic Trinquart, Isabelle Boutron, and Philippe Ravaud (PLoS ONE 8(5): e63677. doi:10.1371/journal.pone.0063677, HTML, XML, and .pdf format, 5p.).
www.plosone.org/article/info%3Adoi%2F10.1371%2Fjournal.pone.0063677
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May 22, 2013
CAAR – US Senate Special Committee on Aging Hearing Testimony – May 22, 2013
“10 Years Later: A Look at the Medicare Prescription Drug Program,” a hearing held May 22, 2013 (witness statements available in .pdf format, full hearing can be viewed in Flash format, running time 1 hour 39 minutes).
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March 5, 2013
CAAR – US Department of Health and Human Services, Office of Inspector General Report – March 5, 2013
“Gaps in Oversight of Conflicts of Interest in Medicare Prescription Drug Decisions,” (OEI-05-10-00450, March 2013, .pdf format, 32p.).
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January 4, 2013
CAAR – Irish Longitudinal Study on Ageing [Trinity College, Dublin, Ireland] Report – January 4, 2013
“Polypharmacy in Adults Over 50 in Ireland: Opportunities for Cost Saving and Improved Healthcare,” by Kathryn Richardson, Patrick Moore, Jure Peklar, Rose Galvin, Kathleen Bennett & Rose Anne Kenny (December 2012, .pdf format, 29p.).
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December 10, 2012
CAAR – Irish Longitudinal Study on Ageing [Trinity College; Dublin, Ireland] Report – December 10, 2012
“Polypharmacy in Adults Over 50 in Ireland: Opportunities for Cost Saving and Improved Healthcare,” by by Kathryn Richardson, Patrick Moore, Jure Peklar, Rose Galvin, Kathleen Bennett & Rose Anne Kenny (December 2012, .pdf format, 29p.).
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November 26, 2012
CAAR – National Bureau of Economics Research Working Papers – November 26, 2012
A. “The Effect of Pharmaceutical Innovation on Longevity: Patient-Level Evidence from the 1996-2002 Medical Expenditure Panel Survey and Linked Mortality Public-Use Files,” by Frank R. Lichtenberg (w18552, November 2012, .pdf format, 23p.).
Abstract:
We investigate the effect of the vintage (year of FDA approval) of the prescription drugs used by an individual on his or her survival and medical expenditure. When we only control for age, sex, and interview year, we estimate that a one-year increase in drug vintage increases life expectancy by 0.52%. Controlling for other variables including activity limitations, race, education, family income as a percent of the poverty line, insurance coverage, Census region, BMI, smoking and over 100 medical conditions has virtually no effect on the estimate of the effect of drug vintage on life expectancy.
Between 1996 and 2003, the mean vintage of prescription drugs increased by 6.6 years. This is estimated to have increased life expectancy of elderly Americans by 0.41-0.47 years. This suggests that not less than two-thirds of the 0.6-year increase in the life expectancy of elderly Americans during 1996-2003 was due to the increase in drug vintage. The 1996-2003 increase in drug vintage is also estimated to have increased annual drug expenditure per elderly American by $207, and annual total medical expenditure per elderly American by $218. This implies that the incremental cost-effectiveness ratio (cost per life-year gained) of pharmaceutical innovation was about $12,900
B. “The Asset Price Meltdown and the Wealth of the Middle Class,” by Edward N. Wolff (w18559, November 2012, .pdf format, 74p.).
Abstract:
I find that median wealth plummeted over the years 2007 to 2010, and by 2010 was at its lowest level since 1969. The inequality of net worth, after almost two decades of little movement, was up sharply from 2007 to 2010. Relative indebtedness continued to expand from 2007 to 2010, particularly for the middle class, though the proximate causes were declining net worth and income rather than an increase in absolute indebtedness. In fact, the average debt of the middle class actually fell in real terms by 25 percent. The sharp fall in median wealth and the rise in inequality in the late 2000s are traceable to the high leverage of middle class families in 2007 and the high share of homes in their portfolio. The racial and ethnic disparity in wealth holdings, after remaining more or less stable from 1983 to 2007, widened considerably between 2007 and 2010. Hispanics, in particular, got hammered by the Great Recession in terms of net worth and net equity in their homes. Households under age 45 also got pummeled by the Great Recession, as their relative and absolute wealth declined sharply from 2007 to 2010.
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September 27, 2012
CAAR – US Department of Health and Human Services, Office of Inspector General Report – September 27, 2012
“Inappropriate Medicare Part D Payments for Schedule II Drugs Billed as Refills,” (OEI-02-09-00605, September 2012, .pdf format, 21p.).
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September 10, 2012
CAAR – National Bureau of Economic Research Working Papers – September 10, 2012
A. “Consumer Inertia and Firm Pricing in the Medicare Part D Prescription Drug Insurance Exchange,” by Keith M. Marzilli Ericson (w18359, September 2012, .pdf format, 32p.).
Abstract:
I use the Medicare Part D prescription drug insurance market to examine the dynamics of firm interaction with consumers on an insurance exchange. Enrollment data show that consumers face switching frictions leading to inertia in plan choice, and a regression discontinuity design indicates initial defaults have persistent effects. In the absence of commitment to future prices, theory predicts firms respond to inertia by raising prices on existing enrollees, while introducing cheaper alternative plans. The complete set of enrollment and price data from 2006 through 2010 confirms this prediction: older plans have approximately 10% higher premiums than comparable new plans.
B. “Recessions, Older Workers, and Longevity: How Long Are Recessions Good For Your Health?” by Courtney C. Coile, Phillip B. Levine, and Robin McKnight (w18361, September 2012, .pdf format, 31p.).
Abstract:
This paper examines the impact of exposure to higher unemployment rates in the pre-retirement years on subsequent mortality. Although past research has found that recessions reduce contemporaneous mortality, these short-term effects may reverse over time, particularly for older workers. If workers experience an economic downturn in their late 50s, they may face several years of reduced employment and earnings before ‘retiring’ when they reach Social Security eligibility at age 62. They also may experience lost health insurance, and therefore higher financial barriers to health care, through age 65, when Medicare becomes available. All of these experiences could contribute to weaker long-term health outcomes. To examine these hypotheses, we use Vital Statistics mortality data between 1969 and 2008 to generate age-specific cohort survival probabilities at older ages. We then link these survival probabilities to labor market conditions at earlier ages. We also use data from the 1980-2010 March Current Population Surveys and the 1991-2010 Behavioral Risk Factor Surveillance System surveys to explore potential mechanisms for this health effect. Our results indicate that experiencing a recession in one’s late 50s leads to a reduction in longevity. We also find that this exposure leads to several years of reduced employment, health insurance coverage, and health care utilization which may contribute to the lower long-term likelihood of survival.
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August 23, 2012
CAAR – Public Library of Science (PLoS) Articles – August 23, 2012
A. “Inappropriateness of Medication Prescriptions to Elderly Patients in the Primary Care Setting: A Systematic Review,” by Dedan Opondo, Saied Eslami, Stefan Visscher, Sophia E. de Rooij, Robert Verheij, Joke C. Korevaar, and Ameen Abu-Hanna (PLoS ONE 7(8): e43617. doi:10.1371/journal.pone.0043617, XML, HTML, and .pdf format, 9p.).
www.plosone.org/article/info%3Adoi%2F10.1371%2Fjournal.pone.0043617
B. “Investigation of Hepatitis B Virus and Human Immunodeficiency Virus Transmission among Severely Mentally Ill Residents at a Long Term Care Facility,” by Supriya Jasuja, Nicola D. Thompson, Philip J. Peters, Yury E. Khudyakov, Megan T. Patel, Purisima Linchangco, Hong T. Thai, William M. Switzer, Anupama Shankar, Walid Heneine, Dale J. Hu, Anne C. Moorman, and Susan I. Gerber (PLoS ONE 7(8): e43252. doi:10.1371/journal.pone.0043252, XML, HTML, and .pdf format, 4p.).
www.plosone.org/article/info%3Adoi%2F10.1371%2Fjournal.pone.0043252
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July 25, 2012
CAAR – Center for Economic Studies/Ifo Institute for Economic Research (CESifo) [Munich, Bavaria, Germany] Working Paper – July 25, 2012
“The Impact of Pharmaceutical Innovation on Longevity and Medical Expenditure in Sweden, 1997-2010: Evidence from Longitudinal, Disease-Level Data,” by Frank Lichtenberg and Billie Pettersson (CESifo Working Paper No. 3894, July 2012, .pdf format, 20p.). Note: Links to the abstract and full-text can be found at:
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July 5, 2012
CAAR – US Department of Health and Human Services, Office of Inspector General Report – July 5, 2012
“Medicare Could Be Paying Twice for Prescription Drugs for Beneficiaries in Hospice,” (A-06-10-00059, June 2012, .pdf format, 20p.).
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March 21, 2012
CAAR – AARP Reports – March 21, 2012
A. “Trends in Retail Prices of Prescription Drugs Widely Used by Medicare Beneficiaries 2005 to 2009,” by Stephen W. Schondelmeyer and Leigh Purvis (March 2012, .pdf format, 15p.).
www.aarp.org/health/drugs-supplements/info-08-2010/rx_price_watch.html
B. “Moving Toward Person- and Family-Centered Care,” by Lynn Feinberg (March 2012, .pdf format, 7p.).
C. “The Employment Situation, February 2012,” by Sara E. Rix (March 2012, .pdf format, 8p.).
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March 7, 2012
CAAR – AARP Reports – March 7, 2012
AARP Reports:
A. “AARP Rx Price Watch Report: Tracking Retail Price Changes for Widely Used Prescription Drugs,” by Stephen W. Schondelmeyer and Leigh Purvis (March 2012, .pdf format, 20p.).
www.aarp.org/health/drugs-supplements/info-08-2010/rx_price_watch.html
B. “The Population of Workers Covered by the Auto IRA: Trends and Characteristics,” by Benjamin H. Harris and Ilana Fischer (February 2012, .pdf format, 14p.).
C. “Economic Effects of Automatic Enrollment in Individual Retirement Accounts,” by Benjamin H. Harris and Rachel M. Johnson (February 2012, .pdf format, 27p.).
D. “The Case for Automatic Enrollment in Individual Retirement Accounts,” by Gary Koenig (February 2012, .pdf format, 5p.).
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