Medicare Part D Plans’ Coverage and Cost-Sharing for Acute Rescue and Preventive Inhalers for Chronic Obstructive Pulmonary Disease

Abstract

Chronic obstructive pulmonary disease (COPD) is the third leading cause of death in the United States,¹ affecting 15.7 million adults¹ and causing nearly 700 000 hospitalizations and 1.7 million emergency department visits in 2012.² Much of the burden of COPD falls heavily on Medicare, with 1 in 9 Medicare beneficiaries diagnosed as having COPD³ and Medicare paying 51% of all US direct health care costs for COPD.⁴ Inhaled medications are key to relieving symptoms and improving health outcomes. However, up to 31% of Medicare beneficiaries using COPD inhalers have reported nonadherence owing to cost.⁵ COPD inhaler costs increased dramatically in 2008, when a ban on chlorofluorocarbon propellants phased out generic inhalers, leaving only brand-name options.⁶ We examined coverage and cost-sharing for COPD inhalers in Medicare Part D plans, which covered 39 million beneficiaries in 2015.