Medicare Part D Cost Sharing and Antipsychotic Use in Two Medicare Advantage Plans

The Affordable Care Act phases out the Medicare Part D coverage gap over the next decade; however, beneficiaries will continue to face substantial cost-sharing even after 2020. Higher cost-sharing has been associated with reductions in necessary drug use. Non-adherence to antipsychotics, a mainstay of schizophrenia treatment, is associated with worse clinical outcomes. We investigated the impact of Part D cost-sharing on antipsychotic spending and adherence for beneficiaries with schizophrenia, focusing on within-person cost-sharing increases associated with the gap.