Applying the 2003 Beers update
to Medicaid/Medicare enrollees
Steven A. Blackwell, Gary M. Ciborowski, David K. Baugh and
Melissa A. Montgomery
Office of Research, Development, and Information,
Centers for Medicare and Medicaid Services, Baltimore, Maryland, USA
Abstract
Purpose – The purpose of this paper is to examine rates of potentially inappropriate prescribing in a
population dually eligible for Medicare and Medicaid using the new 2003 Fick update, which revises
the previous 1997 Beers list.
Design/methodology/approach – Cross sectional retrospective review of 2003 Centers for
Medicare and Medicaid Service (CMS) Medicaid Pharmacy claims data. Claims data submitted for
outpatient and nursing home residents for elderly enrollees dually eligible for Medicare and Medicaid
were analyzed. Potentially inappropriate drug use was assessed using the 2003 Fick update to the
previous 1997 Beers list. Inappropriate use was identified based on these criteria for drugs
independent of diagnosis.
Findings – Of enrollees with drug use, 34 percent received an inappropriate drug per the 1997 Beers
list; 47 percent per the 2003 Fick update. Hispanics had the highest percentage of drug recipients
receiving an inappropriate drug in the Northeast region per the 2003 Fick update. Within therapeutic
category, the number of inappropriate genitourinary products dispensed to total genitourinary
products ranked the highest at 20 percent per the 2003 Fick update.
Practical implications – This study examines variations in Beers drug use in the elderly dually
eligible Medicare and Medicaid population in 2003 by applying the 2003 Fick et al. update of the 1997
Beers list to one of the nation’s largest sources of person-specific data on prescribed drugs.
Inappropriate use was identified for drugs independent of diagnosis. Of enrollees with drug use,
34 percent received an inappropriate drug per the 1997 Beers list; 47 percent per the 2003 Fick update.
Within therapeutic category, the number of inappropriate genitourinary products dispensed to total
genitourinary products ranked the highest at 20 percent per the 2003 Fick update. The paper’s findings
provide evidence that the potential use of inappropriate drugs in Hispanics should be considered
separately from other ethnicity groups.
Originality/value – A markedly higher rate of potentially inappropriate drug use in the elderly
Medicaid population exists following the Fick update. These findings provide evidence that the
potential use of inappropriate drugs in Hispanics should be considered separately from other ethnicity
groups. By comparing drug use based on therapeutic category, genitourinary products were found to
have the highest potential for inappropriate prescribing.
Keywords United States of America, Medical prescriptions, Patient care, Elderly people,
Health insurance
Paper type Research paper
The current issue and full text archive of this journal is available at
www.emeraldinsight.com/1750-6123.htm
The authors are with the Office of Research, Development, and Information, Centers for Medicare
and Medicaid Services (CMS). This research is internally funded. The views and opinions
expressed in this paper are those of the authors and do not necessarily reflect the views of the
CMS. The authors received input and guidance from Bill Clark, Penny Mohr, and Dan Waldo in
the development of this paper. The paper was substantially improved by the contributions of
these individuals.
Medicaid/
Medicare
enrollees
257
International Journal of
Pharmaceutical and Healthcare
Marketing
Vol. 2 No. 4, 2008
pp. 257-272
q Emerald Group Publishing Limited
1750-6123
DOI 10.1108/17506120810922312