Effects of coverage gap reform on adherence to diabetes medications.
Am J Manag Care
; 19(4): 308-16, 2013 Apr.
Article
em En
| MEDLINE
| ID: mdl-23725362
ABSTRACT
OBJECTIVES:
To investigate the impact of Part D coverage gap reform on diabetes medication adherence. STUDYDESIGN:
Retrospective data analysis based on pharmacy claims data from a national pharmacy benefit manager.METHODS:
We used a difference-in-difference-indifference method to evaluate the impact of coverage gap reform on adherence to diabetes medications. Two cohorts (2010 and 2011) were constructed to represent the last year before Affordable Care Act (ACA) reform and the first year after reform, respectively. Each patient had 2 observations 1 before and 1 after entering the coverage gap. Patients in each cohort were divided into groups based on type of gap coverage no coverage, partial coverage (generics only), and full coverage.RESULTS:
Following ACA reform, patients with no gap coverage and patients with partial gap coverage experienced substantial drops in copayments in the coverage gap in 2011. Their adherence to diabetes medications in the gap, measured by percentage of days covered, improved correspondingly (2.99 percentage points, 95% confidence interval [CI] 0.49-5.48, P = .019 for patients with no coverage; 6.46 percentage points, 95% CI 3.34-9.58, P <.0001 for patients with partial coverage). Patients with full coverage also had lower copayments in the gap in 2011. However, their adherence did not increase (-0.13 percentage point, P = .8011).CONCLUSIONS:
In the first year of ACA coverage gap reform, copayments in the gap decreased substantially for all patients. Patients with no coverage and patients with partial coverage in the gap had better adherence in the gap in 2011.
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Base de dados:
MEDLINE
Assunto principal:
Pessoas sem Cobertura de Seguro de Saúde
/
Diabetes Mellitus Tipo 1
/
Diabetes Mellitus Tipo 2
/
Medicare Part D
/
Adesão à Medicação
Tipo de estudo:
Etiology_studies
/
Incidence_studies
/
Observational_studies
/
Risk_factors_studies
Limite:
Aged
/
Aged80
/
Female
/
Humans
/
Male
País/Região como assunto:
America do norte
Idioma:
En
Revista:
Am J Manag Care
Assunto da revista:
SERVICOS DE SAUDE
Ano de publicação:
2013
Tipo de documento:
Article
País de afiliação:
Estados Unidos