Under the Medicare Prescription Drag Improvement and Modernization Act, beneficiaries remaining in the traditional fee-for-service plan will face a variety of drug benefit options provided by private stand-alone prescription drug plans. Although these plans likely will differ with regard to a number of important attributes, little is known about older adults judgment processes in this context. The objectives of this study were to 1) better Understand the manner in which drug insurance attributes ore weighted it] older adults' judgments of drug benefit suitability, 2) explore variability in judgment strategies among seniors, and 3) assess seniors' insight into their judgement policies. Methods. Three focus groups were conducted with 19 older adults to elicit important drug plan attributes. A policy-capturing study with 32 seniors'. none of whom had participated in the focus groups, then was employed to quantify the impacts of these attributes on judgments of plan suitability. Results. Focus group participants reported that copayment, monthly premium, deductible, formulary rise, and mail-order pharmacy Use were important dug insurance attributes. The policy-capturing study showed that deductibles and premiums were weighted most heavily in judgment formation. However, significant variability in judgment policies was apparent, with 3 distinct groups emerging from cluster analysis. The first emphasized deductibles and copayments, the second preimums and deductibles, and the third use of a mail-order pharmacy and deductibles. Study volunteers exhibited insight into the role of some plan attributes in their judgments, but notm others. Conclusions. Cost-shoring provisions appear to be most important in older adults' evaluations of drug benefit plans. However, significant heterogeneity in attribute preferences also was apparent in this studio Older adults may not be cognizant of the manner in which some plan attributes affect their evaluations, suggesting a role for decision aids in this process.
