How Medicare decides prescription drug coverage
Official title: Tradeoffs in the Design of Medicare Prescription Drug Coverage
Funded at Harvard Medical School · NIH-11416705 · Data updated 2026-11-12
This project looks at different ways Medicare covers prescription drugs to find which options help older people afford and get the medicines they need.
Quick facts
| Grant type | P01 program project |
|---|---|
| Study type | NIH-funded research |
| Funding institution | Harvard Medical School NIH-funded |
| Lab location | 1 site (Boston, United States) |
| Project start | August 15, 2009 |
| Project end | April 30, 2030 |
| Funding year | 2026 |
| Award (this year) | $451,784 |
| NIH project number | 5P01AG032952-17 |
| Project ID | NIH-11416705 on NIH RePORTER |
Who could benefit from this research
✓Could help
This is most relevant to Medicare beneficiaries, especially older adults with chronic illnesses, low income, or limited local access to providers.
✕Less likely to help
People who are not on Medicare—for example younger adults with private insurance or the uninsured—are unlikely to see direct benefits from these specific findings.
What this research studies
From a patient's point of view, researchers will analyze Medicare prescription and claims data to compare broad (universal) coverage changes versus targeted help for specific groups. They will examine how cost-sharing, prior authorization, step therapy, and formulary limits affect medication use and out-of-pocket costs. The team will focus on differences across subgroups such as people with multiple chronic conditions, low-income beneficiaries, and those living in rural areas. Using statistical models and policy simulations, they will estimate which coverage designs reduce medication gaps for which patients.
Why it matters
Potential benefit: If successful, this work could inform Medicare policies that make prescriptions more affordable and accessible for people with chronic conditions.
How similar studies have gone: Prior studies have shown that cost-sharing and administrative barriers influence medication use, but directly comparing universal versus targeted coverage across patient subgroups is a newer, less-tested policy approach.
Where this research is happening
-
Harvard Medical School
Boston, United States Active
Researchers
- Principal investigator: Layton, Timothy — Harvard Medical School
- Study coordinator: Layton, Timothy
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About this research
- This is an active NIH-funded research project — typically early-stage science, not a clinical trial accepting patient enrollment.
- Some NIH-funded labs run parallel clinical studies or seek volunteers for related work. To check, contact the principal investigator or institution listed above.
- For full project details, budget, and progress reports, visit the official NIH RePORTER page.