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Research Letter
April 2017

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

Author Affiliations
  • 1Department of Family Medicine and Community Health, University of Hawaii John A. Burns School of Medicine, Honolulu
  • 2Department of Medicine, University of California, San Francisco, San Francisco
  • 3Center for Vulnerable Populations, Department of Medicine (Cardiology), University of California, San Francisco
  • 4Pacific Health Research and Education Institute, Honolulu, Hawaii
JAMA Intern Med. 2017;177(4):585-588. doi:10.1001/jamainternmed.2016.9386

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.