 Another study found that Part D resulted in modest increases in average drug utilization and decreases in average out-of-pocket expenditures.Further studies by the same group of researchers found that the net impact among beneficiaries was a decrease in the use of generic drugs.A further study concludes that although a substantial reduction in out-of-pocket costs and a moderate increase in utilization among Medicare beneficiaries during the first year after Part D, there was no evidence of improvement in emergency department use, hospitalizations, or preference-based health utility for those eligible for Part D during its first year of implementation.