PDS. Prescription Drug Study

PDS. Prescription Drug Study for 2007

item label type description
PDSA1a Question Have you used prescription drugs in the past year?
PDSA1b Question Do you have any insurance that would cover some of the cost of prescription drugs if you did use them?
PDSA2 Question Who does most of the shopping for the prescription drugs that you take?
PDSA3 Question How many different prescription drugs did you use in the last month?
PDSA4 Question Of those prescription drugs, how many are ones you take on a regular basis (for example, every day or every week)?
PDSA5a Question How much do you typically spend of your own money for a one-month supply of your regular drugs?
PDSA5b Question In the last year, what is the most you have spent for a one-month supply of your regular drugs?
PDSA6 Question a typical month, how many different pharmacies do you get prescription drugs from (including mail order)?
PDSA7 Question Where do you typically get your prescription medicines? (Mark (X) all that apply.)
PDSA8 Question How often do you purchase prescription drugs from a supplier in another country such as Canada or Mexico?
PDSA9 Question In addition to your prescription medications, which of the following types of medicines do you regularly use that you buy without a doctor's prescription?
PDSB1 Question Which of the following best describes how your insurance works when you buy prescription drugs?
PDSB2 Question What is the source of your most important prescription drug insurance?A plan provided by my employer, a family member's employer, or a former employer or union..........1
PDSB3 Question What is the name of your most important prescription drug insurance plan?
PDSB4 Question Does your prescription drug coverage have an annual deductible, that is, an amount you have to pay yourself each year before the insurance will start to help pay?
PDSB5 Question If yes, how much is your deductible?
PDSB6 Question What kind of monthly premium is there for your prescription drug insurance?
PDSB7 Question How much is your monthly premium?
PDSB8 Question Some prescription drug insurance plans restrict the number, type or dollar amount of prescriptions they will pay for. Check any of the following types of restrictions that your plan has.My plan won't pay at all for some types of drugs..........1
PDSB9 Question Some prescription drug insurance plans have what's called a coverage gap, or a doughnut hole, where you have to pay all or nearly all of the costs of your drugs for part of the year after the insurance has paid up to a certain amount. Have you reached the coverage gap in your prescription drug plan this year?
PDSB10 Question If you have reached the coverage gap in your plan this year, have you done any of the following to save money after you reached it?
PDSB11 Question Did you cut your spending on drugs early in the year to try to avoid reaching the gap?
PDSB12 Question Overall, how satisfied are you with your current prescription drug coverage?
PDSB13 Question Over the last year, would you say your prescription drug coverage has:
PDSB14 Question In the last year (twelve months), have you done any of the following?
PDSB15 Question In the last year, have you thought about switching to a different provider or a different plan of the same provider?No, I have not thought about switching. I am happy with my plan. No, I have not thought about switching. I wanted to avoid the trouble of going through the whole plan comparison and choice process again. Yes, I have briefly considered switching to a different plan or provider. Yes, I have thoroughly considered switching to a different plan or provider and compared plan details PDS.B16. How would you rate your current prescription drug plan (i.e. the plan in which you are enrolled for 2007) overall?
PDSB17a Question How would you rate Cost of monthly premium of your current prescription drug plan?
PDSB17b Question How would you rate Deductible of your current prescription drug plan?
PDSB17c Question How would you rate Amount you pay for each prescription (co-pay) for drug plan?
PDSB17d Question How would you rate Keeping your costs the same from month to month for your current prescription drug plan?
PDSB17e Question How would you rate these features of your current prescription drug plan - The drugs it covers and doesn't cover (formulary)?
PDSB17f Question How would you rate these features of your current prescription drug plan - Choice of pharmacies or mail order options?
PDSB17g Question How would you rate customer service of your current prescription drug plan?
PDSB18a Question important is Cost of monthly premium of a prescription drug insurance plan for you?
PDSB18b Question important is Deductible of a prescription drug insurance plan for you?
PDSB18c Question important is Amount you pay for each prescription (co-pay) of a prescription drug insurance plan for you?
PDSB18d Question important is Keeping your costs the same from month to month of a prescription drug insurance plan for you?
PDSB18e Question important is The drugs it covers and doesn't cover (formulary) of a prescription drug insurance plan for you?
PDSB18f Question important is Choice of pharmacies or mail order options of a prescription drug insurance plan for you?
PDSB18g Question important is Customer service of a prescription drug insurance plan for you?
PDSB19 Question Please tell us anything else about your prescription drug insurance that you think is important that we have not asked about.
PDSC1a Question In the past year, how often did you not fill a new prescription because of the cost?
PDSC1b Question In the past year, how often did you stop taking a prescription medication because of the cost?
PDSC1c Question In the past year, how often did you skip doses of a prescription medication in order to save money?
PDSC2 Question In the past year, have you had any side effects, unwanted reactions, or other health problems from medications you were taking?
PDSC3a Question Did you cut down or stop taking the drug on your own?
PDSC3b Question Did you talk to a doctor about this reaction?
PDSC3c Question Did you visit a doctor's office or emergency room mostly because of this reaction?
PDSC3d Question Did your doctor ask you to cut down or stop taking the medication because of this reaction?
PDSC3e Question Did you take another medication or treatment to treat this reaction?
PDSC3f Question Were you admitted to a hospital overnight mostly because of this reaction?
PDSD1a Question I had sufficient information to determine whether I would benefit.
PDSD1b Question It was difficult to determine whether specific medications are covered by the plans that are offered.
PDSD1c Question There were too many alternative plans to choose from.
PDSD1d Question It was useful to have more choices of alternative insurers.
PDSD1e Question The enrollment process was very complicated.
PDSD1f Question I had difficulty getting my questions answered.
PDSD1g Question Not all of the medications that Medicare Part D plans promise to cover are actually covered.
PDSD1h Question I have had difficulty getting the prescription drugs that I need covered.
PDSD1i Question I had difficulty understanding how Medicare Part D works and what savings it would provide.
PDSD2a Question Having insurance companies compete for my business improves my options.
PDSD2b Question Having coverage provided through private companies rather than through a single government-managed program complicates my choices.
PDSD2c Question Information on this program provided by Medicare has been useful.
PDSD2d Question Information on this program provided by insurance companies has been useful.
PDSD2e Question It was easy to get my questions answered.
PDSD2f Question The enrollment process was clear and straightforward.
PDSD2g Question The Medicare Part D program is well designed.
PDSD2h Question The Medicare Part D program is a major benefit to seniors.
PDSD2i Question It would have been better to provide drug insurance automatically as part of Medicare, rather than an optional program with multiple providers.
PDSD2j Question Once one gets past the enrollment process, the Part D program works well.
PDSD2k Question The exclusion of some drugs from the lists of what's covered by Medicare Part D plans is a major drawback.
PDSD2l Question The $250 deductible in the Medicare standard plan is a significant drawback.
PDSD2m Question The gap in coverage in the Medicare standard plan between pharmacy bills of $2,250 and $5,100 is a significant drawback.
PDSD2n Question Medicare Part D plans offer significant protection against catastrophic prescription drug costs.
PDSD2o Question Changing formularies of drugs included under Medicare Part D plans makes it difficult to know if drugs one might need in the future will be covered.
PDSD3 Question Are you currently enrolled in a Medicare Part D plan or a Medicare HMO or Advantage plan that helps pay for prescription drugs?
PDSD4 Question Medicare beneficiaries with limited income and resources may qualify to get extra help paying for their prescription drug coverage. Did you know about this program?
PDSD5 Question Have you ever applied for extra help?
PDSD6a Question How helpful do you think the new Medicare prescription drug benefit has been for People with low incomes?
PDSD6b Question How helpful do you think the new Medicare prescription drug benefit has been for People with very high prescription drug costs?
PDSD6c Question How helpful do you think the new Medicare prescription drug benefit has been for People with low prescription drug costs?
PDSD6d Question How helpful do you think the new Medicare prescription drug benefit has been for People with no other insurance for drugs?
PDSD6e Question How helpful do you think the new Medicare prescription drug benefit has been for People with good other insurance coverage for drugs?
PDSD6f Question How helpful do you think the new Medicare prescription drug benefit has been for A typical person with Medicare?
PDS7a Question I am more likely to make a wrong choice if I have lots of different options to choose from.
PDS7b Question When it comes to making decisions about my health insurance coverage, I prefer to have someone knowledgeable decide for me.
PDS7c Question I prefer to have lots of information about each option.
PDS7d Question I prefer to choose a plan without help from anyone.
PDS7e Question Choosing a Medicare plan is a task I would rather avoid.
PDS7f Question I often feel overwhelmed because there is too much information about each plan to take in.
PDS7g Question I have difficulty understanding the information about Medicare coverage options.
PDS7h Question Whenever I make a choice about Medicare, I worry it will be the wrong one.
PDS7i Question I am confused about the changes in Medicare.
PDS7j Question I am upset about the changes to Medicare.
PDS8 Question Who do you trust or count on to help you make choices about health insurance? (Mark (X) all that apply.)
PDSE1a Question Please write down some information from the label on the prescription bottle.Name of the medication:
PDSE1b Question Please write down some information from the label on the prescription bottle.Strength
PDSE1c Question Please write down some information from the label on the prescription bottle.Medication Format/Unit
PDSE1d Question Please write down some information from the label on the prescription bottle. Dosage Instructions
PDSE2 Question About how long have you been taking this medication?
PDSE3 Question How much did you pay the last time you filled this prescription?
PDSE4a Question This medication is very important for my health.
PDSE4b Question It often gives me unpleasant side effects.
PDSE4c Question It is too expensive.
PDSE4d Question It is the best one available for what it does.
PDSE5 Question In the last year, have you ever missed a scheduled dose of this medication or delayed or not filled a prescription for it?
PDSE6a Question How important was Cost for missing a dose or not filling a prescription when that happened?
PDSE6b Question How important was Unpleasant side effects for missing a dose or not filling a prescription when that happened?
PDSE6c Question How important was being Away from home for missing a dose or not filling a prescription when that happened?
PDSE6d Question How important was Forgetting for missing a dose or not filling a prescription when that happened?
PDSF1 Question Please list any other prescription medications that you take (do not include any medications you told us about before in Section E).
PDSG1 Question Please list any medications that you take regularly or as often as needed without a doctor's prescription (do not include any medications you told us about before in Section E). Examples could be things like aspirin, antacids allergy medicine, or herbal medications.
PDSH1 Question Were the questions in this questionnaire answered by the person to whom this questionnaire was addressed, or did someone else answer for that person?
PDSH2 Question Approximately, how long did it take you to complete this questionnaire?(minutes)
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