| Summary: | Limited information exists about enrollment in Part D prescription coverage by Medicare beneficiaries with cancer. Part D coverage may increase access to medicines. This study evaluated patterns of Part D uptake and costs and assessed the effects of coverage on hospitalizations and emergency department (ED) use among people with colorectal cancer (CRC). We analyzed Surveillance, Epidemiology, and End Results (SEER)-Medicare linked data on fee-for-service (FFS) Medicare beneficiaries with at least 36 months of follow-up who were diagnosed with CRC at any point from January 2007 through December 2010, and a matched cohort of beneficiaries without cancer. Dual (Medicare/Medicaid) enrollees were excluded because they are automatically enrolled in Part D. Among beneficiaries with CRC (n = 12,774), 39 percent had complete Part D coverage, defined as coverage in the diagnosis year and 2 subsequent years; the rate was 38 percent in the matched comparison cohort (P = .119). Among those with complete Part D coverage, there was no significant difference in annual prescription drug costs between people with CRC ($3,157, 95% confidence interval [CI]: $3,098-$3,216) and without ($3,113, 95% CI: $3,054-$3,172). Among people with CRC, odds of ED use ranged from unchanged to marginally higher for those with no or partial Part D coverage, (adjusted odds ratio: 1.09, 95% CI: 1.00-1.18), compared with those with complete Part D coverage. Lack of continuous Part D coverage was associated with more ED use among Medicare FFS beneficiaries with CRC in 2007-2013. Among people with Part D coverage, prescription drug costs varied little between those with CRC and matched beneficiaries without cancer
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