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https://www.readbyqxmd.com/read/28813219/association-of-reference-pricing-with-drug-selection-and-spending
#1
James C Robinson, Christopher M Whaley, Timothy T Brown
Background In the United States, prices for therapeutically similar drugs vary widely, which has prompted efforts by public and private insurers to steer patients toward the lower-priced options. Under reference pricing, the insurer or employer establishes a maximum contribution it will make toward the price of a drug or procedure, and the patient pays the remainder. Methods We used difference-in-differences multivariable regression methods to analyze changes in prescriptions and pricing for 1302 drugs in 78 therapeutic classes in the United States, before and after implementation of reference pricing by an alliance of private employers...
August 17, 2017: New England Journal of Medicine
https://www.readbyqxmd.com/read/28793067/farm%C3%A3-cia-popular-program-pharmaceutical-market-analysis-of-antihypertensive-acting-on-the-renin-angiotensin-system-medicines
#2
Rondineli Mendes da Silva, Gabriela Costa Chaves, Luisa Arueira Chaves, Mônica Rodrigues Campos, Vera Lucia Luiza, Andréa Dâmaso Bertoldi, Dennis Ross-Degnan, Isabel Cristina Martins Emmerick
This paper aims to analyse changes in the retail pharmaceutical market following policy changes in the Farmácia Popular Program (FP), a medicines subsidy program in Brazil. The retrospective longitudinal analyses focus on therapeutic class of agents acting on the renin-angiotensin system. Data obtained from QuintilesIMS (formerly IMS Health) included private retail pharmacy sales volume (pharmaceutical units) and sales values from 2002 to 2013. Analyses evaluated changes in market share following key FP policy changes...
August 2017: Ciência & Saúde Coletiva
https://www.readbyqxmd.com/read/28792299/impact-of-medicaid-prescription-copayments-on-use-of-antipsychotics-and-other-medications-in-patients-with-schizophrenia
#3
Jalpa A Doshi, Pengxiang Li, Sunita Desai, Steven C Marcus
OBJECTIVE: To assess the impact of Medicaid prescription copayment policies on antipsychotic and other medication use among patients with schizophrenia. METHOD: The study sample included fee-for-service adult Medicaid patients with schizophrenia. Medicaid claims records from 2003-2005 from 42 states and D.C. were linked with county-level data from the Area Resource File and findings from a state Medicaid policy survey. Patient-level fixed-effects regression models examined the impact of increases in generic copayments and generic/brand copayment differentials on monthly use of antipsychotic (overall and by generic/brand status) and other non-antipsychotic medications...
August 9, 2017: Journal of Medical Economics
https://www.readbyqxmd.com/read/28791752/is-higher-population-level-use-of-ics-laba-combination-associated-with-better-asthma-outcomes-cross-sectional-surveys-of-nationally-representative-populations-in-new-zealand-and-australia
#4
Helen K Reddel, Lutz Beckert, Angela Moran, Tristram Ingham, Rosario D Ampon, Matthew J Peters, Susan M Sawyer
BACKGROUND AND OBJECTIVE: New Zealand (NZ) and Australia (AU) have similarly high asthma prevalence; both have universal public health systems, but different criteria for subsidized medicines. We explored differences in asthma management and asthma-related outcomes between these countries. METHODS: A web-based survey was administered in AU (2012) and NZ (2013) to individuals aged ≥16 years with current asthma, drawn randomly from web-based panels, stratified by national population proportions...
August 9, 2017: Respirology: Official Journal of the Asian Pacific Society of Respirology
https://www.readbyqxmd.com/read/28777235/cost-effectiveness-of-health-coaching-an-integrative-review
#5
Rachel Hale, Jeannie Giese
PURPOSE/OBJECTIVES: The purpose of this review was to evaluate published literature to distinguish how health coaching influences the cost of chronic disease management in insured adults with chronic conditions. PRIMARY PRACTICE SETTING: An integrated literature review was conducted. MEDLINE, Business Source Complete, and OneSearch were searched for the years 2001-2016 utilizing the following key words: health coaching, health coaching AND insurance companies, health coaching AND cost, health coaching AND health insurance, and health coaching AND insurance cost...
September 2017: Professional Case Management
https://www.readbyqxmd.com/read/28776113/the-impact-of-copayments-on-mental-healthcare-utilization-a-natural-experiment
#6
Timo R Lambregts, René C J A van Vliet
Empirical evidence suggests that people are fairly sensitive to cost sharing arrangements in ambulatory mental healthcare. However, pure cost sharing effects are typically hard to measure due to the presence of adverse selection effects. In this paper, we examine the impact of cost sharing on mental healthcare utilization in the context of mandatory health insurance where adverse selection is absent. Using a large proprietary dataset of a Dutch private health insurer, we examine to what extent a new copayment scheme for adult mental healthcare changed healthcare utilization...
August 3, 2017: European Journal of Health Economics: HEPAC: Health Economics in Prevention and Care
https://www.readbyqxmd.com/read/28755097/provider-experiences-with-chronic-care-management-ccm-services-and-fees-a-qualitative-research-study
#7
Ann S O'Malley, Rumin Sarwar, Rosalind Keith, Patrick Balke, Sai Ma, Nancy McCall
BACKGROUND: Support for ongoing care management and coordination between office visits for patients with multiple chronic conditions has been inadequate. In January 2015, Medicare introduced the Chronic Care Management (CCM) payment policy, which reimburses providers for CCM activities for Medicare beneficiaries occurring outside of office visits. OBJECTIVE: To explore the experiences, facilitators, and challenges of practices providing CCM services, and their implications going forward...
July 28, 2017: Journal of General Internal Medicine
https://www.readbyqxmd.com/read/28745476/extending-marketplace-tax-credits-would-make-coverage-more-affordable-for-middle-income-adults
#8
Jodi Liu, Christine Eiber
ISSUE: Affordability of health coverage is a growing challenge for Americans facing rising premiums, deductibles, and copayments. The Affordable Care Act's tax credits make marketplace insurance more affordable for eligible lower-income individuals. However, individuals lose tax credits when their income exceeds 400 percent of the federal poverty level, creating a steep cliff. GOALS: To analyze the effects of extending eligibility for tax credits to individuals with incomes above 400 percent of the federal poverty level...
July 2017: Issue Brief of the Commonwealth Fund
https://www.readbyqxmd.com/read/28736929/impact-of-cost-sharing-increases-on-continuity-of-specialty-drug-use-a-quasi-experimental-study
#9
Pengxiang Li, Tianyan Hu, Xinyan Yu, Salim Chahin, Nabila Dahodwala, Marissa Blum, Amy R Pettit, Jalpa A Doshi
OBJECTIVE: To examine the impact of cost-sharing increases on continuity of specialty drug use in Medicare beneficiaries with multiple sclerosis (MS) or rheumatoid arthritis (RA). DATA SOURCES/STUDY SETTING: Five percent Medicare claims data (2007-2010). STUDY DESIGN: Quasi-experimental study examining changes in specialty drug use among a group of Medicare Part D beneficiaries without low-income subsidies (non-LIS) as they transitioned from a 5 percent cost-sharing preperiod to a ≥25 percent cost-sharing postperiod, as compared to changes among a disease-matched contemporaneous control group of patients eligible for full low-income subsidies (LIS), who faced minor cost sharing (≤$6...
July 24, 2017: Health Services Research
https://www.readbyqxmd.com/read/28732518/impact-of-the-change-of-copay-policy-in-medicare-part-d-on-zoster-vaccine-uptake-among-medicare-beneficiaries-in-a-managed-care-organization
#10
Rulin C Hechter, Lei Qian, Songkai Yan, Yi Luo, Girishanthy Krishnarajah, Hung-Fu Tseng
BACKGROUND: Kaiser Permanente Southern California (KPSC) adopted the Medicare Part D Tier-6 with zero patient copay for zoster vaccination in 2012. We assessed the impact of the implementation on zoster vaccination rate (GSK study identifier: HO-13-14,182). METHODS: Zoster vaccination rate was examined among an open cohort of ≥65-year-old Medicare Part D beneficiaries during 01/01/2008-06/30/2014, compared to ≥65-year-old commercial health plan members and 60-64-year-old members...
July 21, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28675119/what-do-patients-want-from-otolaryngologists-a-discrete-choice-experiment
#11
Matthew R Naunheim, Vinay K Rathi, Margaret L Naunheim, Blake C Alkire, Allen C Lam, Phillip C Song, Mark G Shrime
Objectives Patient preferences are crucial for the delivery of patient-centered care. Discrete choice experiments (DCEs) are an emerging quantitative methodology used for understanding these preferences. In this study, we employed DCE techniques to understand the preferences of patients presenting for an ear, nose, and throat clinic visit. Study Design DCE. Setting Decision science laboratory. Methods A DCE survey of 5 attributes-wait time, physician experience, physician personality, utilization of visit time, and cost/copayment-was constructed with structured qualitative interviews with patients...
June 1, 2017: Otolaryngology—Head and Neck Surgery
https://www.readbyqxmd.com/read/28664240/understanding-patients-preferences-for-surgical-management-of-urethral-stricture-disease
#12
Lindsay A Hampson, Tracy K Lin, Leslie Wilson, Isabel E Allen, Thomas W Gaither, Benjamin N Breyer
OBJECTIVES: To understand how prioritization of treatment attributes and treatment choice varies by patient characteristics, we sought to specifically determine how demographic variables affect patient treatment preference. PATIENTS AND METHODS: Male patients with urethral stricture disease participated in a choice-based conjoint (CBC) analysis exercise evaluating six treatment attributes associated with internal urethrotomy and urethroplasty. Demographic and past symptom data were collected...
June 29, 2017: World Journal of Urology
https://www.readbyqxmd.com/read/28663023/epidemiological-trends-and-direct-costs-of-diabetes-in-a-northern-italy-area-2012-health-administrative-records-analysis-lht-n-20-verona
#13
J Demurtas, N Alba, G Rigon, M V Nesoti, C Bovo, A Vaona
OBJECTIVE: This analysis estimates type 1 and type 2 diabetes direct costs in 2012, in terms of hospital care, outpatient visits, diagnostics and medications, in a local healthcare trust in Northern Italy (ULSS n.20 Verona). METHODS: The Johns Hopkins Adjusted Clinical Group (ACG(®)) System was used to analyze data, including hospital discharges, emergency room admissions, medical encounter records, disease registries, copayment exemptions, home care services, psychiatric services, rehabilitation services, and medications...
June 26, 2017: Primary Care Diabetes
https://www.readbyqxmd.com/read/28660657/pay-less-consume-more-the-price-elasticity-of-home-care-for-the-disabled-elderly-in-france
#14
Quitterie Roquebert, Marianne Tenand
Little is known about the price sensitivity of demand for home care of the disabled elderly. We partially fill this knowledge gap by using administrative data on the beneficiaries of the main French home care subsidy program in a department and exploiting interindividual variation in provider prices. We address the potential endogeneity of prices by taking advantage of the unequal spatial coverage of providers and instrumenting price by the number of municipalities served by a provider. We estimate a price elasticity of around -0...
June 29, 2017: Health Economics
https://www.readbyqxmd.com/read/28640674/racial-ethnic-minority-older-adults-perspectives-on-proposed-medicaid-reforms-effects-on-dental-care-access
#15
Mary E Northridge, Ivette Estrada, Eric W Schrimshaw, Ariel P Greenblatt, Sara S Metcalf, Carol Kunzel
To examine how proposed Medicaid reform plans are experienced by racial/ethnic minority older adults and what the implications are for their ability to access dental care through Medicaid, from 2013 to 2015 we conducted focus groups in northern Manhattan, New York, New York, among African American, Dominican, and Puerto Rican adults aged 50 years and older. Participants reported problems with affording copayments for care, complicated health and social issues, the need for vision and dental care close to home, and confusion about and stigmatization with Medicaid coverage...
May 2017: American Journal of Public Health
https://www.readbyqxmd.com/read/28637723/impact-of-consumer-copayments-for-subsidised-medicines-on-health-services-use-and-outcomes-a-protocol-using-linked-administrative-data-from-western-australia
#16
Karla L Seaman, Frank M Sanfilippo, Elizabeth E Roughead, Max K Bulsara, Anna Kemp-Casey, Caroline Bulsara, Gerald F Watts, David Preen
INTRODUCTION: Across the world, health systems are adopting approaches to manage rising healthcare costs. One common strategy is a medication copayments scheme where consumers make a contribution (copayment) towards the cost of their dispensed medicines, with remaining costs subsidised by the health insurance service, which in Australia is the Federal Government.In Australia, copayments have tended to increase in proportion to inflation, but in January 2005, the copayment increased substantially more than inflation...
June 21, 2017: BMJ Open
https://www.readbyqxmd.com/read/28629454/impact-of-pharmacy-channel-on-adherence-to-oral-oncolytics
#17
Michael Stokes, Carolina Reyes, Yu Xia, Veronica Alas, Hans-Peter Goertz, Luke Boulanger
BACKGROUND: Oral chemotherapy is increasingly prescribed to treat cancer. Despite its benefits, concerns have been raised regarding adherence to therapy. The study objective was to compare and measure adherence, persistence, and abandonment in patients filling prescriptions in traditional retail (TR) versus specialty pharmacy (SP) channels. METHODS: Using a retrospective cohort design, we selected newly treated patients aged ≥18 years with a prescription for erlotinib, capecitabine, or imatinib during 2007-2011 from a Medco population of both United States commercial and Medicare health plans...
June 19, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28627151/-assessment-of-an-algorithm-to-identify-paediatric-onset-celiac-disease-cases-through-administrative-healthcare-databases
#18
Gisella Pitter, Roberto Gnavi, Pierantonio Romor, Renzo Zanotti, Lorenzo Simonato, Cristina Canova
OBJECTIVES: to assess the role of four administrative healthcare databases (pathology reports, copayment exemptions, hospital discharge records, gluten-free food prescriptions) for the identification of possible paediatric cases of celiac disease. DESIGN: population-based observational study with record linkage of administrative healthcare databases. SETTING AND PARTICIPANT S: children born alive in the Friuli Venezia Giulia Region (Northern Italy) to resident mothers in the years 1989-2012, identified using the regional Medical Birth Register...
January 2017: Epidemiologia e Prevenzione
https://www.readbyqxmd.com/read/28626503/does-a-free-office-visit-affect-primary-care-seeking-behavior-a-study-of-new-exchange-health-plan-enrollees-in-mississippi
#19
Bettina M Beech, Tristan Cordier, Laura E Happe, Laura Trunk, Gilbert S Haugh, Richard Kwong, Vipin Gopal, Roy A Beveridge
BACKGROUND: Given the positive association between primary care and overall health, several health plans are offering doctors' visits without patient copay, with the intent to increase primary care use. However, the effectiveness of these offers has not been established in the literature. OBJECTIVE: To evaluate the impact of a free primary care provider (PCP) office visit offered by a health plan on primary care-seeking behaviors. METHODS: This nonrandomized concurrent control study used event/trials logistic regression to compare the differences in primary care utilization between new exchange enrollees in Mississippi who were offered a free nonpreventive PCP visit and concurrent controls from Georgia and Tennessee who were not offered a free visit, between January 1, 2014, and December 31, 2014, which was the first year of the exchange plans...
April 2017: American Health & Drug Benefits
https://www.readbyqxmd.com/read/28615965/impact-of-a-value-based-insurance-design-for-physical-therapy-to-treat-back-pain-on-care-utilization-and-cost
#20
Daniel D Maeng, Anthony Graboski, Peiling L Allison, Dorothy Y Fisher, John B Bulger
OBJECTIVE: To assess the impact of a value-based insurance design providing enhanced access to physical therapy (PT) for treatment of back pain on treatment patterns and cost of care. STUDY DESIGN: A retrospective analysis of claims data obtained from Geisinger Health Plan (GHP). In April 2013, GHP began offering "PT bundle" - i.e., a bundle of up to five PT visits for a single one-time copay that can be renewed for another bundle of five PT visits - for its employer-based plan members with back pain...
2017: Journal of Pain Research
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