Date of download: 5/28/2016 From: Effect of the Medicare Part D Coverage Gap on Medication Use Among Patients With Hypertension and Hyperlipidemia Ann.

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Exhibit 1 NOTES: LIS is Low-Income Subsidy. PDP is prescription drug plan. MA-PD is Medicare Advantage Prescription Drug Plan. Analysis includes non-LIS.
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Date of download: 5/28/2016 From: Effect of the Medicare Part D Coverage Gap on Medication Use Among Patients With Hypertension and Hyperlipidemia Ann Intern Med. 2012;156(11): doi: / Study flow diagram. LIS = low-income subsidy. Figure Legend: Copyright © American College of Physicians. All rights reserved.American College of Physicians

Date of download: 5/28/2016 From: Effect of the Medicare Part D Coverage Gap on Medication Use Among Patients With Hypertension and Hyperlipidemia Ann Intern Med. 2012;156(11): doi: / Average out-of-pocket cost per 30-day supply prescription filled for all antihypertensive and lipid-lowering drugs before and during the coverage gap. Error bars indicate 95% CIs. LIS = low-income subsidy. Figure Legend: Copyright © American College of Physicians. All rights reserved.American College of Physicians

Date of download: 5/28/2016 From: Effect of the Medicare Part D Coverage Gap on Medication Use Among Patients With Hypertension and Hyperlipidemia Ann Intern Med. 2012;156(11): doi: / Adjusted changes in number of 30-day supply antihypertensive and lipid-lowering prescriptions available by beneficiaries in months before and during the coverage gap, compared with the control group of low-income subsidy patients. Month 0 represents the calendar month of entry into the coverage gap. The figures are based on mean differences in adjusted 30-day supply prescriptions available per month for each study group relative to the control group of fully eligible low-income subsidy patients. The adjusted 30-day supply prescriptions used per month were estimated with segmented regression models using generalized estimating equations with first-order, autoregressive correlation structure; variables for study groups, coverage gap status, months, and months after entering coverage gap; and interaction terms between group indicators and time-related variables. Data were adjusted for age, sex, race and ethnicity, Medicare entitlement status, metropolitan status (urban or rural), census region of residence, area-level characteristics (per capita income, unemployment rate, and education level) in beneficiary's county of residence, and prescription drug hierarchical condition category risk score. Error bars indicate 95% CIs obtained with 500 bootstrapped replicates. Figure Legend: Copyright © American College of Physicians. All rights reserved.American College of Physicians

Date of download: 5/28/2016 From: Effect of the Medicare Part D Coverage Gap on Medication Use Among Patients With Hypertension and Hyperlipidemia Ann Intern Med. 2012;156(11): doi: / Adjusted changes in adherence rates of antihypertensive and lipid-lowering prescriptions used by beneficiaries in months before and during the coverage gap, compared with the control group of low-income subsidy patients. Month 0 represents the calendar month of entry into the coverage gap. The figures are based on mean differences in adjusted monthly adherence rates for each study group relative to the control group of fully eligible low-income subsidy patients. The adjusted monthly adherence rates were estimated with segmented regression models using generalized estimating equations with first-order, autoregressive correlation structure; variables for study groups, coverage gap status, months, and months after entering coverage gap; and interaction terms between group indicators and time-related variables. Data were adjusted for age, sex, race and ethnicity, Medicare entitlement status, metropolitan status (urban or rural), census region of residence, area-level characteristics (per capita income, unemployment rate, and education level) in beneficiary's county of residence, and prescription drug hierarchical condition category risk score. Error bars indicate 95% CIs obtained with 500 bootstrapped replicates. Figure Legend: Copyright © American College of Physicians. All rights reserved.American College of Physicians

Date of download: 5/28/2016 From: Effect of the Medicare Part D Coverage Gap on Medication Use Among Patients With Hypertension and Hyperlipidemia Ann Intern Med. 2012;156(11): doi: / Adjusted changes in number of 30-day supply acid suppressant, pain reliever, and antidepressant prescriptions available by beneficiaries in months before and during the coverage gap, compared with the control group of low-income subsidy patients. Month 0 represents the calendar month of entry into the coverage gap. The figures are based on mean differences in adjusted 30-day supply prescriptions available per month for each study group relative to the control group of fully eligible low-income subsidy patients. The adjusted 30-day supply prescriptions used per month were estimated with segmented regression models using generalized estimating equations with first-order, autoregressive correlation structure; variables for study groups, coverage gap status, months, and months after entering coverage gap; and interaction terms between group indicators and time-related variables. Data were adjusted for age, sex, race and ethnicity, Medicare entitlement status, metropolitan status (urban or rural), census region of residence, area-level characteristics (per capita income, unemployment rate, and education level) in beneficiary's county of residence, and prescription drug hierarchical condition category risk score. Error bars indicate 95% CIs obtained with 500 bootstrapped replicates. Figure Legend: Copyright © American College of Physicians. All rights reserved.American College of Physicians