{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,4]],"date-time":"2026-08-04T22:25:27Z","timestamp":1785882327313,"version":"3.56.0"},"reference-count":58,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2021,12,14]],"date-time":"2021-12-14T00:00:00Z","timestamp":1639440000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100000133","name":"Agency for Healthcare Research and Quality","doi-asserted-by":"publisher","award":["T32HS000029"],"award-info":[{"award-number":["T32HS000029"]}],"id":[{"id":"10.13039\/100000133","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100014848","name":"Arnold Ventures","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100014848","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Health Services Research"],"published-print":{"date-parts":[[2022,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>Examine whether Medicare Advantage (MA) coverage is associated with more efficient prescribing of Part B drugs than traditional Medicare (TM) coverage.<\/jats:p><\/jats:sec><jats:sec><jats:title>Data Sources<\/jats:title><jats:p>Twenty percent sample of 2016 outpatient and carrier TM claims and MA encounter records and Master Beneficiary Summary File data.<\/jats:p><\/jats:sec><jats:sec><jats:title>Study Design<\/jats:title><jats:p>We analyzed whether MA enrollees compared to TM enrollees more often received the low\u2010cost Part B drug in four clinical scenarios where multiple similarly effective drugs exist: (1) anti\u2010VEGF agents to treat macular degeneration, (2) bone resorption inhibitors for osteoporosis, (3) bone resorption inhibitors for malignant neoplasms, and (4) intravenous iron for iron deficiency anemia. We then estimated differences in spending if TM prescribing aligned with MA prescribing. Finally, using linear probability models, we examined whether differences in MA and TM prescribing patterns were attributable to differences in the hospitals and clinician practices who treat MA and TM enrollees or differences in how these hospitals and clinician practices treat their MA versus TM patients.<\/jats:p><\/jats:sec><jats:sec><jats:title>Data Collection\/Extraction Methods<\/jats:title><jats:p>Not applicable.<\/jats:p><\/jats:sec><jats:sec><jats:title>Principal Findings<\/jats:title><jats:p>In all cases, a larger share of MA enrollees received the low\u2010cost drug compared to TM enrollees, ranging from 8 percentage points higher for anemia to 16 percentage points higher for macular degeneration in the unadjusted analysis. Results were similar in regression analyses controlling for enrollee characteristics and market factors (5\u201313 percentage points). If TM prescribing matched MA prescribing, we estimated savings ranging from 6% to 20% of TM spending for each scenario. Differences in prescribing patterns were driven both by MA enrollees receiving treatment at more efficient hospitals and clinician practices and hospitals and clinician practices more often prescribing low\u2010cost drugs to their MA patients.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Our findings show MA enrollees were more likely than TM enrollees to receive low\u2010cost Part B drugs in four clinical scenarios where multiple similarly or equally effective treatment options exist.<\/jats:p><\/jats:sec>","DOI":"10.1111\/1475-6773.13912","type":"journal-article","created":{"date-parts":[[2021,11,22]],"date-time":"2021-11-22T06:16:42Z","timestamp":1637561802000},"page":"537-547","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":14,"title":["Prescribing of low\u2010 versus <scp>high\u2010cost<\/scp> Part B drugs in Medicare Advantage and traditional Medicare"],"prefix":"10.1111","volume":"57","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1471-6283","authenticated-orcid":false,"given":"Kelly E.","family":"Anderson","sequence":"first","affiliation":[{"name":"Department of Health Policy and Management Johns Hopkins Bloomberg School of Public Health  Baltimore Maryland USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel","family":"Polsky","sequence":"additional","affiliation":[{"name":"Department of Health Policy and Management Johns Hopkins Bloomberg School of Public Health, Johns Hopkins Carey Business School, Hopkins Business of Health Initiative  Baltimore Maryland USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sydney","family":"Dy","sequence":"additional","affiliation":[{"name":"Department of Health Policy and Management Johns Hopkins Bloomberg School of Public Health, Johns Hopkins School of Medicine, Division of General Internal Medicine  Baltimore Maryland USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7203-2736","authenticated-orcid":false,"given":"Aditi P.","family":"Sen","sequence":"additional","affiliation":[{"name":"Department of Health Policy and Management Johns Hopkins Bloomberg School of Public Health  Baltimore Maryland USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2021,12,14]]},"reference":[{"key":"e_1_2_8_2_1","unstructured":"MedPAC.Medicare and the health care delivery system. chapter 3: Medicare payment strategies to improve price competition and value for part B drugs. Medicare Payment Advisory Commission. Report to the Congress. Washington DC: June 2019.http:\/\/medpac.gov\/docs\/default-source\/reports\/jun19_medpac_reporttocongress_sec.pdf."},{"key":"e_1_2_8_3_1","unstructured":"Assistant Secretary for Planning and Evaluation (ASPE). Office of Health Policy.Medicare part B drugs: trends in spending and utilization 2006\u20102017. Issue Brief. November 20 2020.https:\/\/aspe.hhs.gov\/system\/files\/pdf\/264416\/Part-B-Drugs-Trends-Issue-Brief.pdf. Accessed April 9 2021"},{"key":"e_1_2_8_4_1","unstructured":"WerbleC.Medicare part B. Health Affairs. Health Policy Brief. Prescription Drug Pricing #5. August 10 2017.https:\/\/www.healthaffairs.org\/do\/10.1377\/hpb20171008.000171\/full\/. 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