Potential savings from increasing adherence to inhaled corticosteroid therapy in Medicaid-enrolled children.
Am J Manag Care
; 21(3): 173-80, 2015 Mar.
Article
in En
| MEDLINE
| ID: mdl-25880622
ABSTRACT
BACKGROUND:
Many asthma-related exacerbations could be prevented by consistent use of daily inhaled corticosteroid therapy (ICS-Rx).OBJECTIVES:
We sought to measure the potential cost savings that could accrue from increasing ICS-Rx adherence in children. STUDYDESIGN:
We measured observed costs for a cohort of 43,156 Medicaid-enrolled children in 14 southern states whose initial ICS-Rx was prescribed in 2007.METHODS:
Adherence rates and associated costs were calculated from Medicaid claims. Children were categorized as high or low adherence based on the ratio of ICS-Rx claims filled to total asthma drug claims. Branching tree simulation was used to project the potential cost savings achieved by increasing the proportion of children with ICS-Rx to total asthma Rx ratios greater than 0.5 to 20%, 40%, 60%, 80%, and 100%.RESULTS:
Increasing the proportion of children who maintain higher adherence after initial ICS-Rx to 40% would generate savings of $95 per child per year. An intervention costing $10 per member per month that resulted in even half of the children maintaining high adherence would generate a 98% return on investment for managed care plans or state Medicaid programs. Net costs decreased incrementally at each level of increase in ICS-Rx adherence. The projected Medicaid cost savings for these 14 states in 2007 ranged from $8.2 million if 40% of the children achieved high adherence, to $57.5 million if 80% achieved high adherence.CONCLUSIONS:
If effective large-scale interventions can be found, there are substantial cost savings to be gained from even modest increases in real-world adherence to ICS-Rx among Medicaid-enrolled children with asthma.
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Asthma
/
Medication Adherence
/
Glucocorticoids
Limits:
Child
/
Child, preschool
/
Humans
Country/Region as subject:
America do norte
Language:
En
Journal:
Am J Manag Care
Journal subject:
SERVICOS DE SAUDE
Year:
2015
Document type:
Article