Impact of multitiered copayments on the use and cost of prescription drugs among Medicare beneficiaries.
Health Serv Res
; 43(2): 478-95, 2008 Apr.
Article
em En
| MEDLINE
| ID: mdl-18370964
ABSTRACT
OBJECTIVES:
To assess the impact of multitiered copayments on the cost and use of prescription drugs among Medicare beneficiaries. DATA SOURCES Marketscan 2002 Medicare Supplemental and Coordination of Benefits database and Plan Benefit Design database. STUDYDESIGN:
The study uses cross-sectional variation in copayment structures among firms with a self-insured retiree health plan to measure the impact of number of copayment tiers on total and enrollee drug payments, number of prescriptions filled, and generic substitution. The study also assesses the effect of enrollee cost sharing on the cost and use of prescription medications for the long-term treatment of chronic conditions. DATA COLLECTIONMETHODS:
We linked plan enrollment and benefit data with medical and drug claims for 352,760 Medicare beneficiaries with employer-sponsored retiree drug coverage. PRIMARYFINDINGS:
Medicare beneficiaries in three-tiered plans had 14.3 percent lower total drug expenditures, 14.6 percent fewer prescriptions filled, and 57.6 percent higher out-of-pocket costs than individuals in lower tiered plans. They also had fewer brand name and generic prescriptions filled, and a higher percentage of generics. The estimated price elasticity of demand for prescription drug expenditures was -0.23. Finally, for maintenance medications used for the long-term treatment of chronic conditions, members in three-tiered plans had 11.5 percent fewer prescriptions filled.CONCLUSIONS:
Higher tiered drug plans reduce overall expenditures and the number of prescriptions purchased by Medicare beneficiaries. Beneficiaries are less responsive to cost sharing incentives when using drugs to treat chronic conditions.
Texto completo:
1
Temas:
ECOS
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Aspectos_gerais
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Financiamentos_gastos
Bases de dados:
MEDLINE
Assunto principal:
Dedutíveis e Cosseguros
Tipo de estudo:
Health_economic_evaluation
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Observational_studies
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Prevalence_studies
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Risk_factors_studies
Aspecto:
Patient_preference
Limite:
Aged
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Aged80
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Female
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Humans
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Male
País/Região como assunto:
America do norte
Idioma:
En
Revista:
Health Serv Res
Ano de publicação:
2008
Tipo de documento:
Article
País de afiliação:
Estados Unidos