• From 1992 to 2001, the proportion of community-dwelling 

persons aged 65 and over 

who reported using prescribed 

medicines during the calendar 

year increased 6 percentage 

points—from 85.3 percent to 

91.6 percent.

• For community-dwelling 

persons aged 65 and over who 

used prescribed medicine during the year:

• The mean number of prescribed medicines (fills or 

refills) increased from 18.8 

in 1992 to 27.8 in 2001. 

• Mean total expenses for 

prescribed medicines more 

than doubled—from $535 

in 1992 to $1,410 in 2001. 

• Among community-dwelling 

persons aged 65 and over who 

used prescribed medicine in 

2001, on average, those in 

fair to poor health used more 

prescribed medicines than those 

in very good to excellent health, 

women used more than men, 

non-Hispanic black persons 

used more than non-Hispanic 

white persons, and those with 

an annual income of $10,000 or 

less used more prescribed medicines than those with an annual 

income greater than $50,000.

• In 2001, those communitydwelling persons aged 65 and 

over without drug insurance 

coverage, on average, had 

lower prescribed medicine 

use and lower total prescribed 

medicine expenses but higher 

out-of-pocket (OOP) spending 

for prescribed medicines than 

those with drug coverage.

Overview

The importance of prescription drug use in medical 

practice in the United States has grown with the availability of new drugs to treat major diseases, including 

common chronic conditions such as heart disease, 

hypertension, and depression. As a result, prescription 

drug use and spending have increased. Spending on 

retail prescription drugs in the United States more than 

tripled from $15.0 billion in 1982 to $48.2 billion in 

1992, then more than tripled again to $162.4 billion 

in 2002. In per capita terms, retail prescription drug 

spending increased from $64 in 1982 to $569 in 2002. 

As a proportion of national health expenditures, retail 

prescription drug spending more than doubled from 4.7 

percent in 1982 to 10.5 percent in 2002.1

This report focuses on changes in prescription drug use 

and spending for persons aged 65 and over (hereafter referred to as older persons), who, compared with younger 

persons, are heavy users of prescription medicines. 

Medicare beneficiaries, most of whom are aged 65 and 

over, made up 14 percent of the community population 

in 2001 but accounted for 41 percent of prescription 

medicine expenses.2 Prescribed medicine expenditures 

for Medicare beneficiaries aged 65 and over increased 

from $13.9 billion in 1992 to $35.6 billion in 2000.3,4

Monitoring increasing prescription drug use and spending among older Americans is important for three 

reasons. First, monitoring prescription drug use for 

subgroups of the older population is a way to identify 

disparities in drug use and possible underutilization. 

Second, there are concerns about the financial burden 

from increasing drug costs for older persons, particularly those with low incomes. Third, the rising cost of 

Highlights

By Margie R. Goulding, Ph.D.

February 2005
2 

prescription drugs to third-party payers is an important consideration for both private 

and public health plans, including Medicare, which is scheduled to start a prescription 

drug benefit in 2006. 

This report focuses on annual prescribed medicine use and spending for older Americans residing in the community. The calendar year is the reference period for the estimates of prescribed medicine use and spending. Nursing home residents were excluded 

from the analysis because they tend to be older and more disabled than community 

dwellers, and their access to pharmaceutical care may be influenced by different factors. The prescribed medicine use and spending estimates in this report were derived 

from information collected in the Medicare Current Beneficiary Survey, a survey of 

a nationally representative sample of Medicare beneficiaries. (For more information, 

see “About the data.”)

How has prescribed medicine use by community-dwelling older 

Americans changed? 

The percentage of community-dwelling older Americans using prescribed 

medicines increased between 1992 and 2001.

Among community-dwelling older persons in the United States, the percentage that 

reported use of one or more prescribed medicines during the year increased from 85.3 

in 1992 to 91.6 in 2001. Both men and women experienced increases in the percentage 

using prescribed medicines. The estimates for women were 3.5–5.9 percentage points 

higher than for men.In addition, there were some differences among age groups. In each 

year from 1992 to 2001, the percentage reporting prescribed medicine use was lower 

for the 65–74 year age group compared with the 75–84 year age group. The percentages 

were similar for the 75–84 year age group and the 85 years and over age group. 

The average number of prescribed 

medicines used by communitydwelling older Americans 

increased substantially over the 

period from 1992 to 2001. 

Among community-dwelling older 

persons with at least one prescribed 

medicine used during the year, the 

mean number of prescribed medicines used in the year increased 

from 18.8 in 1992 to 27.8 in 2001. 

(The prescribed medicines count 

includes both original fills and refills 

of a prescription. The count does not 

provide information on the number 

Figure 1. Mean annual number of prescribed medicines 

per user for community-dwelling Medicare beneficiaries with 

prescribed medicine use, by age group, 1992–2001

NOTE: The prescribed medicines count includes both original fills and refills of a 

prescription. The count does not provide information on the number of medications with distinct chemical entities.

Number of prescribed medicines per user
3

of medications with distinct chemical entities.) All sex and age subgroups experienced 

increases. The increase was 8.5 prescribed medicines for those aged 65–74 years, 9.1 

for those aged 75–84 years, and 10.4 for those aged 85 years and over (figure 1). 

The increase was 7.7 prescribed medicines for men aged 65 and over and 10 for women 

aged 65 and over. 

Although the mean is a useful summary measure, it does not show the skewed nature 

of prescribed medicine use among older persons. While one-half of the communitydwelling older persons with prescribed medicine use (referred to as prescribed medicine users) reported using 21 or fewer prescribed medicines during 2001, 25 percent 

reported 39 or more, 10 percent reported 60 or more, and 5 percent reported using 76 

or more prescribed medicines. These figures represented substantial increases from 

1992 (table 1). 

How has prescribed medicine spending for community-dwelling 

older Americans changed?

 

Per capita spending on prescribed 

medicines for prescribed medicine 

users more than doubled between 

1992 and 2001.

The increases in annual prescribed medicine use discussed above were reflected 

in increases in annual prescribed medicine spending. Mean annual spending 

per user was $1,410 in 2001 compared 

with $535 in 1992 (figure 2). This is a 

164-percent nominal increase or an 88-

percent increase after adjusting for drug 

price inflation. (The Centers for Medicare & Medicaid Services’ price index 

for prescription drugs was used to 

Figure 2. Mean annual total prescribed medicine expenses 

per user and mean annual out-of-pocket (OOP) prescribed 

medicine expenses per user, nominal and inflation-adjusted, 

for community-dwelling Medicare beneficiaries aged 65 and 

over with prescribed medicine use, 1992–2001

NOTE: The Centers for Medicare & Medicaid Services’ price index for 

prescription drugs was used to adjust for drug price increases. It is difficult to 

measure drug price increases because the quality of the basket of drugs also 

has improved over time.

Mean 18.8 27.8 $535 $1,410 $312 $533

Median (50th percentile) 13 21 $350 $991 $166 $315

75th percentile 26 39 $735 $1,908 $418 $693

90th percentile 42 60 $1,236 $3,135 $787 $1,278

95th percentile 55 76 $1,662 $4,213 $1,093 $1,761

Number of

prescribed medicines per user

Total prescribed

medicine expenses per user

OOP1 prescribed

medicine expenses per user

1992 2001

Characteristic

1992 2001 1992 2001

1

OOP is out-of-pocket.

NOTES: The prescribed medicines count includes both original fills and refills of a prescription during the year. The count does not provide 

information on the number of medications with distinct chemical entities. Expense estimates are in nominal dollars.

Table 1. Annual number of prescribed medicines per user and annual prescribed medicine expenses per 

user —mean and selected percentiles—for community-dwelling Medicare beneficiaries aged 65 and over 

with prescribed medicine use, 1992 and 2001
4 

adjust for drug price increases. It is difficult to measure drug price increases because 

the quality of the basket of drugs also has improved over time.) Mean spending more 

than doubled in all three age groups (65–74, 75–84, and 85 and over) and for both 

sexes.

However, as with prescribed medicine use, the mean does not reveal the skewed distribution of prescribed medicine spending. In 2001, one-half of the community-dwelling 

older persons with prescribed medicine use had expenses of $991 or less for the year 

while one-quarter had expenses of $1,908 or more, 10 percent had $3,135 or more, 

and 5 percent had $4,213 or more. These dollar figures are more than double what 

they were in 1992 (table 1). 

Thus, both prescribed medicine use and expenses of community-dwelling older 

Americans demonstrated substantial growth between 1992 and 2001. Although the 

increase in prescribed medicine consumption generally has not been viewed with 

concern, the rapid increase in spending is a concern, as it can put a financial burden on 

older persons. Thus, it is of interest to know how much of older persons’ prescription 

drug costs are paid directly out of their own pockets and how such spending has 

changed over time. 

Per capita out-of-pocket spending on prescribed medicines for prescribed 

medicine users increased about 70 percent between 1992 and 2001.

On average, community-dwelling older prescribed medicine users paid $312 out of 

pocket (OOP) for prescribed medicines in 1992 and $533 in 2001—a 71-percent 

nominal increase (22-percent increase after controlling for drug price inflation) (figure 

2). Out-of-pocket spending, like total spending, on prescribed medicines is skewed. 

In 2001, one-half of the community-dwelling older persons with prescribed medicine 

use spent $315 or less OOP on prescribed medicines, while 25 percent spent $693 

or more OOP, 10 percent spent $1,278 or more OOP, and 5 percent spent $1,761 

or more OOP (table 1). The median for OOP spending in 2001 ($315) is almost 90 

percent higher than it was in 1992 ($166), and the other three percentiles (75th, 90th, 

and 95th) are about 60 percent higher than they were in 1992. Despite these increases, 

for prescribed medicine users, OOP spending as a share of total prescribed medicine 

expenses declined between 1992 and 2001. 

The next section examines differences in prescribed medicine use, expenses, and OOP 

spending for subgroups of the community-dwelling older population. It is important to 

examine these differences to see if there is evidence of underutilization of prescribed 

medicines or a heavy financial burden from OOP spending on prescribed medicines 

for vulnerable or disadvantaged groups.
5

What factors are related to differences in prescribed 

medicine use and spending?

Self-reported health status and chronic conditions

In 2001, community-dwelling older prescribed medicine users who reported fair to poor 

health, compared with those who reported very good to excellent health, on average, 

had 88 percent more prescribed medicines, 85 percent higher total prescribed medicine 

expenses, and 63 percent higher OOP spending on prescribed medicines. Those in fair 

or poor health, on average, used 38.9 prescribed medicines during the year compared 

with 20.7 for those in very good or excellent health (table 2). Those in fair or poor 

health, on average, had prescribed medicine expenses of $1,985, with $694 paid OOP, 

compared with those in very good or excellent health who had $1,070 in prescribed 

medicine expenses, with $427 paid OOP. 

In 2001, community-dwelling older prescribed medicine users who reported none of 11 

chronic conditions or chronic condition groups had much lower prescribed medicine use 

and expenses, on average, than those who reported three or more of these conditions. 

(The 11 chronic conditions or chronic condition groups are hardening of the arteries; 

hypertension; myocardial infarction; angina or coronary heart disease; other heart 

conditions; stroke; cancer; diabetes; arthritis; rheumatoid arthritis; and emphysema, 

asthma, or chronic obstructive pulmonary disease.) Those with none of the 11 chronic 

conditions had, on average, about 35–40 percent of the annual prescribed medicine 

use and expenses of those with three or more chronic conditions—12.8 versus 36.9 

prescribed medicines, $655 versus $1,854 in prescribed medicine expenses, and $265 

versus $668 in OOP spending on prescribed medicines (table 2). 

All 27.8 $1,410 $533

Self-reported health: 

 Very good–excellent 20.7 $1,070 $427

 Fair–poor 38.9 $1,985 $694

Chronic conditions:

 0 12.8 $655 $265

 3 or more 36.9 $1,854 $668

Mean annual

Number of prescribed

medicines per user

Total prescribed

medicine expenses per user

OOP1 prescribed

medicine expenses per user

Table 2. Mean annual number of prescribed medicines per user and mean annual prescribed medicine 

expenses per user, for community-dwelling Medicare beneficiaries aged 65 and over with prescribed medicine 

use, by self-reported health status and chronic conditions, 2001

1

OOP is out-of-pocket.

NOTES: The prescribed medicines count includes both original fills and refills of a prescription during the year. The count does not provide 

information on the number of medications with distinct chemical entities. The 11 counted chronic conditions or condition groups are these: 

hardening of the arteries; hypertension; myocardial infarction; angina or coronary heart disease; other heart conditions; stroke; cancer; 

diabetes; arthritis; rheumatoid arthritis; and emphysema, asthma, or chronic obstructive pulmonary disease. For the prescribed medicine 

use and expense measures, the differences between the two categories for both health measures are all statistically significant. 

Characteristic
6 

Sex, age, and race/ethnicity 

For community-dwelling older prescribed medicine users in 2001, on average, men 

had about 21 percent fewer prescribed medicines than women (24.8 versus 29.9), 12 

percent lower prescribed medicine expenses ($1,319 versus $1,475), and 27 percent 

lower OOP spending on prescribed medicines ($460 versus $584) (table 3). By age, 

average prescribed medicine use, expenses, and OOP spending were modestly higher 

(14 percent, 7 percent, and 16 percent, respectively) for those community-dwelling 

prescribed medicine users in the 75 years and over age group compared with the 65–74 

age group in 2001 (table 3). By race, the percentages of community-dwelling older 

persons with prescribed medicine use were similar for non-Hispanic white persons 

and black persons in 2001. However, among these users, non-Hispanic black persons 

had a modestly higher (13 percent) mean number of prescribed medicines than nonHispanic white persons (31.2 versus 27.7) (table 3). But non-Hispanic black persons 

had about the same total prescribed medicine expenses and 22 percent lower OOP 

prescribed medicine spending than non-Hispanic white persons in 2001. 

Among community-dwelling older persons with prescribed medicine use, some of the 

higher prescribed medicine use in 2001 by women, non-Hispanic black persons, and 

persons aged 75 and over, may be explained by a higher prevalence of chronic conditions. 

Among these prescribed medicine users in 2001, only 4.9 percent of those aged 75 

and over had none of 11 chronic conditions compared with 10.9 percent for those aged 

65–74. The percentages were 5.7 for non-Hispanic black persons compared with 8.1 

for non-Hispanic white persons and 7.2 for women compared with 9.2 for men. 

Sex

All 27.8 $1,410 $533 

Men 24.8 $1,319 $460

Women 29.9 $1,475 $584

Age

65–74 years 26.1 $1,363 $495

75 years and over 29.6 $1,461 $574

Race/ethnicity

Non-Hispanic white 27.7 $1,445 $559

Non-Hispanic black 31.2 2$1,337 $458

Income

 $10,000 and under 32.7 $1,395 $415

 $50,001 and over 22.9 2$1,401 $499

Mean annual

Number of prescibed

medicines per user

Total prescribed medicine

expenses per user

OOP1 prescribed medicine

expenses per user 

1

OOP is out-of-pocket.

2 The difference is not statistically significant.

NOTES: The prescribed medicines count includes both original fills and refills of a prescription during the year. The count does not provide 

information on the number of medications with distinct chemical entities. For the prescribed medicine use and expense measures, the 

differences between the two categories for these demographic characteristics are statistically significant except where noted in footnote #2.

Table 3. Mean annual number of prescribed medicines per user and mean annual prescribed medicine 

expenses per user, for community-dwelling Medicare beneficiaries aged 65 and over with prescribed medicine use, by demographic characteristics, 2001

Characteristic
7

Income 

The percentage of community-dwelling older persons with prescribed medicine use in 

2001 was slightly higher for those with an annual income between $30,001 and $50,000 

compared with those with $10,000 or less in annual income. However, the percentages 

were similar for the $10,000 or less income group and the above $50,000 income group. 

For these community-dwelling older prescribed medicine users, the low income group 

($10,000 or less) had, on average, almost 10 more prescribed medicines (32.7 versus 

22.9) than the above $50,000 income group in 2001 (table 3). This may be explained 

partly by more chronic illnesses among those in the low income group compared with 

the above $50,000 income group (3.05 versus 2.31 conditions on average). 

Despite the higher prescribed medicine use in 2001 for the low income group, there 

was no difference in average total prescribed medicine expenses for these two income 

groups (table 3). The above $50,000 income group, on average, did have 20 percent 

higher OOP prescribed medicine spending than the $10,000 or less income group 

($499 versus $415) in 2001. However, $415 in OOP spending for those with $10,000 

or less in annual income is probably more of a financial burden than $499 OOP for 

those with $50,000 or more in annual income. 

Another factor affecting prescribed medicine purchases is whether the person has drug 

insurance coverage. Differences in prescribed medicine use and spending by drug 

coverage are explored next.

Drug insurance coverage 

The percentage of community-dwelling older persons with prescription drug insurance 

coverage at any point during the year rose from 58.8 in 1992 to 79.5 in 2001. Persons 

counted as having drug coverage were those with third-party (private or public) payments for prescribed medicines; administrative records showing full Medicaid coverage 

in any month; administrative records showing participation in the Qualified Medicare 

Beneficiary (QMB) or Specified Low-Income Medicare Beneficiary (SLMB) Medicaid 

programs in any month combined with a Medicaid payment for prescribed medicines; 

or self-report of drug coverage for those with private supplemental insurance.

For those community-dwelling older persons with drug coverage, 94.1 percent reported 

prescribed medicine use in 2001, compared with only 81.9 percent for those without 

drug coverage. In addition, among prescribed medicine users, on average, those with 

drug coverage had 28.7 prescribed medicines in 2001 compared with 23.8 for those 

without drug coverage (table 4). The estimates for all community-dwelling older 

persons (not just those with prescribed medicine use) are 27.0 and 19.5 prescribed 

medicines, on average, for those with and without drug coverage, respectively. 

For disadvantaged or vulnerable subgroups of community-dwelling older prescribed 

medicine users, there are increased differentials by drug coverage status. For those in 

fair to poor health, the difference is almost 8 prescribed medicines (40.3 versus 32.5) 
8 

5 Poisal JA, Chulis GS. Medicare 

beneficiaries and drug coverage. 

Health Aff (Millwood) 19:248–56. 

2000.

6

 Poisal JA, Murray L. Growing 

differences between Medicare 

beneficiaries with and without drug 

coverage. Health Aff (Millwood) 

20:74–85. 2001.

7

 Curtis LH, Law AW, Anstrom KJ, 

Schulman KA. The insurance effect 

on prescription drug expenditures 

among the elderly: Findings from 

the 1997 Medical Expenditure Panel 

Survey. Med Care 42:439–46. 2004.

8

 Blustein J. Drug coverage and 

drug purchases by Medicare beneficiaries with hypertension. Health 

Aff (Millwood) 19:219–30. 2000.

9

 Federman AD, Adams AS, RossDegnan D, et al. Supplemental 

insurance and use of effective 

cardiovascular drugs among 

elderly Medicare beneficiaries with 

coronary heart disease. JAMA 286:

1732–9. 2001.

10 Doshi JA, Brandt N, Stuart B. 

The impact of drug coverage on 

COX-2 inhibitor use in Medicare. 

Health Affairs (Web exclusive) W–4:94–105. 2004. http:

//content.healthaffairs.org/cgi/

content/full/hlthaff.w4.94v1/DC1. 

Nov 24, 2004.

for those with and without drug coverage in 2001 (table 4). For those with $10,000 or 

less in annual income, the difference is 10 prescribed medicines (34.6 versus 24.5) for 

those with and without drug coverage in 2001. These differences may be indicators 

of underutilization by those without drug coverage. Methods that control for potential 

confounders would be needed to test that hypothesis. 

The prescribed medicine expenses for community-dwelling older prescribed medicine 

users with drug coverage in 2001 were $1,511, on average, compared with $959 for 

those without drug coverage—a 58-percent difference (table 4). Differences ranging 

from 28 percent to 51 percent were seen from 1992 to 2000. 

There are also substantial differences in annual OOP spending. Prescribed medicine 

users without drug coverage had 72 percent and 105 percent higher OOP prescribed 

medicine spending than those with drug coverage in 1992 and 2001, respectively. 

(These estimates exclude insurance premiums and, therefore, do not include additional 

premium costs paid by those with a drug benefit compared with those without a drug 

benefit.) In 2001, OOP prescribed medicine spending was $447 for those with drug 

coverage and $915 for those without it (table 4). This level of OOP spending may be a 

financial burden, particularly for low income persons. In 2001, for those with $10,000 

or less in annual income and no drug coverage, annual OOP spending on prescribed 

medicines, on average, was $855. 

These continuing differences by drug coverage status are not unanticipated. Several 

studies have shown an association between drug insurance coverage and higher 

prescribed medicine use or spending, overall 5–7 or for specific types of medications, 8–10

for older Americans. Equally important, and not well known, results are the tripling over 

1992–2001 in the difference in mean total prescribed medicine expenses (in nominal 

dollars) for those community-dwelling older persons with drug coverage compared 

with those without drug coverage. The gaps in mean OOP prescribed medicine 

spending (nominal) for those with and without drug coverage also grew—almost 

All 28.7 23.8 $1,511 $959 $447 $915 

Fair–poor health 40.3 32.5 $2,130 $1,318 $575 $1,241

Annual income 

$10,000 or less 34.6 24.5 $1,509 $906 $312 $855

Mean Annual

Number of prescribed

medicines per user

Total prescribed medicine

expenses per user

OOP1 prescribed medicine

expenses per user

Table 4. Mean annual number of prescribed medicines per user and mean annual prescribed medicine 

expenses per user, for community-dwelling Medicare beneficiaries aged 65 and over with prescribed medicine 

use, by drug coverage, self-reported health status, and income, 2001

1

OOP is out-of-pocket

NOTES: The differences between the estimates for those with and without drug coverage are all statistically significant. For persons without 

drug coverage, the main reason for differences in the mean total and out-of-pocket (OOP) prescribed medicine expense estimates is the inclusion of uncollected liability (sometimes a discount given to the purchaser) in the total expense estimates but not the OOP expense estimates. If 

one were to assume all the uncollected liabilities were discounts and adjust total prescribed medicine expenses by subtracting these amounts, 

for community-dwelling older persons with prescribed medicine use the mean total prescribed medicine expenses would be $1,483 for those 

with drug coverage and $918 for those without it. These amounts are not significantly different from the amounts in the table. 

Characteristic

With drug

coverage

Without drug

coverage

With drug

coverage

With drug

coverage

Without drug

coverage

Without drug

coverage
9

tripled—between 1992 and 2001. In addition, for those persons with $10,000 or less 

in annual income and no drug coverage, mean OOP prescribed medicine spending 

(nominal) more than doubled between 1992 and 2001.

Summary

The estimates presented show substantial changes in prescribed medicine use and expenses for community-dwelling older persons in the United States. The proportion of 

this population with prescribed medicine use, the mean number of prescribed medicines 

per user, and the mean prescribed medicine expenses per user increased from 1992 to 

2001. Factors contributing to these increases may include: 

• An increase in chronic illness among community-dwelling older persons, 

• Availability of new prescribed medicines to treat many chronic conditions,

• Decreases in the share of prescribed medicine expenses paid OOP by community-dwelling older persons, linked to increases in the share of this population 

with drug insurance coverage, and

• Increases in prescription drug prices. 

Although the increases between 1992 and 2001 in prescribed medicine use and spending 

occurred in all examined subgroups of older Americans, sizeable differentials across 

groups may suggest unequal access to prescribed medicines, reflecting differences in 

income, drug insurance coverage, and other access factors. 

Outside of major advances in nonpharmaceutical preventive medicine, it seems reasonable to assume that the use of prescribed medicines will grow among the older 

population in the United States. However, there is substantial uncertainty surrounding 

predictions of prescription drug use and spending by this population given the uncertainty surrounding two important factors: 

(1) Future pharmaceutical advances in medical areas affecting older persons 

and

(2) The future extent and depth of drug insurance coverage among older Americans after implementation of the Medicare drug benefit in 2006. 

As these changes take place, continued monitoring of prescribed medicine use and 

spending by older Americans is warranted.
10

About the data

The estimates of prescribed medicine use and spending in this report were derived 

from information collected in the Medicare Current Beneficiary Survey (MCBS). The 

MCBS is a survey of a nationally representative sample of Medicare beneficiaries that 

has been conducted by the Centers for Medicare & Medicaid Services (formerly the 

Health Care Financing Administration) since September 1991. In 2001, about 96 percent 

of the U.S. population aged 65 and over was enrolled in Medicare. The estimates in 

this report are based on information from community-dwelling MCBS respondents 

aged 65 and over. Persons under age 65 and persons who resided in nursing homes 

were excluded from the analysis. 

Community-dwelling Medicare beneficiaries who participate in the MCBS are 

interviewed in their homes three times a year. The MCBS “Cost and Use” data file 

includes information—both from beneficiary reporting and from Medicare claims—on 

the use of health care services during the calendar year and related expenditures. The 

prescribed medicines information in the MCBS is self-reported because Medicare 

currently does not cover most outpatient drugs. At each interview, survey respondents 

are asked about any prescribed medicines they used since the last interview. They are 

asked to report any medicine they obtained by filling or refilling prescriptions or having 

a prescription phoned in to a pharmacy. To reduce recall error, respondents are asked 

to keep and bring to the interview their prescription bottles, packages, and receipts. 

In addition, the interviewers have a list of prescribed medicines previously reported 

by the respondent and ask if he/she used any of those medicines during the period of 

interest. Nevertheless, some underreporting of the number of prescribed medicines 

used and prescribed medicine expenditures is expected.11

For more information on the MCBS, see http://www.cms.hhs.gov/mcbs.

Suggested citation

Goulding MR. Trends in prescribed medicine use and spending by older Americans, 

1992–2001. Aging Trends, No. 5. Hyattsville, Maryland: National Center for Health 

Statistics. 2005.

Acknowledgment

I would like to thank James Lubitz, M.P.H., National Center for Health Statistics, for 

his guidance on this report.

11 Poisal JA. Reporting of drug 

expenditures in the MCBS. Health 

Care Financ Rev 25:23–36. 2003.