Cost-sharing and initiation of disease-modifying therapy for multiple sclerosis.
Am J Manag Care
; 18(8): 460-4, 2012 08.
Article
em En
| MEDLINE
| ID: mdl-22928761
ABSTRACT
OBJECTIVES:
To assess the effects of patient cost sharing on initiation of disease-modifying therapies (DMTs) in multiple sclerosis (MS). STUDYDESIGN:
Retrospective claims database study of privately insured patients newly diagnosed with MS between 2004 and 2008 from 33 large employers.METHODS:
We assessed the effects of plan-level cost-sharing on DMT initiation during a 2-year follow-up period after diagnosis. Incident cases were identified by 2 or more claims with ICD-9 codes for MS within a year, subsequent to a year with no such claims. Covariates for adjustment included age, gender, relationship to primary beneficiary, comorbid conditions, and calendar year, as well as unobserved factors that did not vary within plans over time.RESULTS:
Out of a sample of 3460 patients meeting criteria for inclusion, only 17% initiated a DMT within 2 years of diagnosis. An increase in the cost-sharing rate from zero to the 95th percentile (17.8%) was predicted to decrease initiation within 2 years of diagnosis by 2.9 percentage points, or 12.7% (P = .019).CONCLUSIONS:
High cost-sharing is associated with delayed initiation of effective MS therapies.
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Coleções:
01-internacional
Contexto em Saúde:
1_ASSA2030
Base de dados:
MEDLINE
Assunto principal:
Custo Compartilhado de Seguro
/
Imunomodulação
/
Esclerose Múltipla
Tipo de estudo:
Diagnostic_studies
/
Health_economic_evaluation
/
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Limite:
Adult
/
Female
/
Humans
/
Male
País/Região como assunto:
America do norte
Idioma:
En
Revista:
Am J Manag Care
Ano de publicação:
2012
Tipo de documento:
Article