{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T09:53:27Z","timestamp":1791453207353,"version":"4.3.3"},"reference-count":30,"publisher":"Oxford University Press (OUP)","issue":"10","license":[{"start":{"date-parts":[[2026,8,3]],"date-time":"2026-08-03T00:00:00Z","timestamp":1785715200000},"content-version":"vor","delay-in-days":214,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000049","name":"National Institute on Aging","doi-asserted-by":"publisher","award":["P30AG097158"],"award-info":[{"award-number":["P30AG097158"]}],"id":[{"id":"10.13039\/100000049","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000049","name":"National Institute on Aging","doi-asserted-by":"publisher","award":["RF1AG083175"],"award-info":[{"award-number":["RF1AG083175"]}],"id":[{"id":"10.13039\/100000049","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,9,8]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background and Objectives<\/jats:title>\n                    <jats:p>This study examined Medicare Part D and Part B drug spending and beneficiary out-of-pocket (OOP) costs among community-dwelling Medicare fee-for-service (FFS) beneficiaries with Alzheimer\u2019s disease and related dementias (ADRD), assessing variation by dual eligibility, state, and Accountable Care Organization (ACO) enrollment.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Research Design and Methods<\/jats:title>\n                    <jats:p>We conducted a cross-sectional analysis using the 2022 Medicare Beneficiary Summary File linked to the Cost and Use file. The sample included 1\u2009372\u2009696 community-dwelling Medicare FFS beneficiaries with ADRD, including 575\u2009308 beneficiaries with five or more chronic conditions. Outcomes included annual Medicare payments and beneficiary OOP costs for Parts D and B drugs. Analyses were stratified by dual eligibility duration, state, and ACO enrollment, with adjusted estimates from generalized linear models.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Medicare Part D drug spending was substantial, increasing with dual-eligibility duration: $8732-$9107 among beneficiaries with full-year dual eligibility and exceeding $11\u2009500 among those with 5+ chronic conditions. Beneficiary OOP costs were highest among Medicare-only beneficiaries and markedly lower among dually eligible individuals. Medicare Part B drug spending was highest among Medicare-only beneficiaries and varied widely by state, ranging from $433 to $1827 among Medicare-only beneficiaries and from $179 to $1446 among dually eligible beneficiaries. After adjustment, differences in Parts D and B drug spending by ACO enrollment were modest.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion and Implications<\/jats:title>\n                    <jats:p>Parts D and B drug costs among Medicare beneficiaries with ADRD vary by dual eligibility and geography. Limited associations with ACO enrollment underscore the need for better medication management integration in value-based care for high-need older adults with ADRD.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/geroni\/igag085","type":"journal-article","created":{"date-parts":[[2026,7,31]],"date-time":"2026-07-31T11:47:11Z","timestamp":1785498431000},"source":"Crossref","is-referenced-by-count":0,"title":["Variation in Medicare Part D and Part B drug spending among older adults with Alzheimer\u2019s disease and related dementias"],"prefix":"10.1093","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0009-0000-0826-6530","authenticated-orcid":false,"given":"Seyeon","family":"Jang","sequence":"first","affiliation":[{"name":"Department of Health Policy and Management, University of Maryland School of Public Health , College Park, Maryland,","place":["United States"]},{"name":"Center for Seniors Uniting Nationwide to Support Health, INtegrated care, and Economics (SUNSHINE), University of Maryland , College Park, Maryland,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jie","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Health Policy and Management, University of Maryland School of Public Health , College Park, Maryland,","place":["United States"]},{"name":"Center for Seniors Uniting Nationwide to Support Health, INtegrated care, and Economics (SUNSHINE), University of Maryland , College Park, Maryland,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2026,8,3]]},"reference":[{"key":"2026100805270022700_igag085-B1","doi-asserted-by":"publisher","first-page":"86","DOI":"10.3390\/brainsci11010086","article-title":"Pain, complex chronic conditions, and potential inappropriate medication in people with dementia: lessons learnt for pain treatment plans utilizing data from the Veteran Health Administration","volume":"11","author":"Husebo","year":"2021","journal-title":"Brain Sci."},{"key":"2026100805270022700_igag085-B2","doi-asserted-by":"publisher","first-page":"542","DOI":"10.1186\/s13063-020-04482-0","article-title":"The OPTIMIZE patient- and family-centered, primary care\u2013based deprescribing intervention for older adults with dementia or mild cognitive impairment and multiple chronic conditions: study protocol for a pragmatic cluster randomized controlled trial","volume":"21","author":"Bayliss","year":"2020","journal-title":"Trials."},{"key":"2026100805270022700_igag085-B3","doi-asserted-by":"publisher","first-page":"e2433026","DOI":"10.1001\/jamanetworkopen.2024.33026","article-title":"Prescription drug costs among people with Alzheimer disease and related dementias","volume":"7","author":"Jang","year":"2024","journal-title":"JAMA Netw 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