Read Books Online and Download eBooks, EPub, PDF, Mobi, Kindle, Text Full Free.
Copayments And The Demand For Prescription Drugs
Download Copayments And The Demand For Prescription Drugs full books in PDF, epub, and Kindle. Read online Copayments And The Demand For Prescription Drugs ebook anywhere anytime directly on your device. Fast Download speed and no annoying ads. We cannot guarantee that every ebooks is available!
Book Synopsis Copayments and the Demand for Prescription Drugs by : Domenico Esposito
Download or read book Copayments and the Demand for Prescription Drugs written by Domenico Esposito and published by Routledge. This book was released on 2006-04-18 with total page 168 pages. Available in PDF, EPUB and Kindle. Book excerpt: Increasing prescription drug cost-sharing by patients - in the form of increasing copayments - is one of the most striking, and controversial, developments in the health sector over recent years. The exact nature and use of copayments by health care insurers continues to be hot topic of debate. This detailed and meticulously researched study is one of the first of its kind: its results suggest that differences in copayments influence choice, shifting market share for these drugs. Differential copayments for medically equivalent alternatives is one strategy insurers use to affect the choice of one drug over another when faced with differing prices. Relative copayments for therapeutically equivalent drugs, imposed by insurers, are shown to have a significant impact on consumer choice – the implication being that physicians are acting in patients’ financial, as well as medical interest. Unlike much work in this area, Copayments and the Demand for Prescription Drugs is not sponsored by any drug company; and its up-to-date results, established on a firm scientific basis, are entirely unbiased. Its results have applications for the private insurance and pharmaceutical sectors as well as the public sector, and it will be of great interest to professionals and researchers in the fields of health economics, economic and healthcare policy-making, and microeconomics: its primary findings are especially critical to the United States public health sector which is on the cusp of providing a prescription drug benefit to nearly forty million elderly Americans.
Author :National Academies of Sciences, Engineering, and Medicine Publisher :National Academies Press ISBN 13 :0309468086 Total Pages :235 pages Book Rating :4.3/5 (94 download)
Book Synopsis Making Medicines Affordable by : National Academies of Sciences, Engineering, and Medicine
Download or read book Making Medicines Affordable written by National Academies of Sciences, Engineering, and Medicine and published by National Academies Press. This book was released on 2018-03-01 with total page 235 pages. Available in PDF, EPUB and Kindle. Book excerpt: Thanks to remarkable advances in modern health care attributable to science, engineering, and medicine, it is now possible to cure or manage illnesses that were long deemed untreatable. At the same time, however, the United States is facing the vexing challenge of a seemingly uncontrolled rise in the cost of health care. Total medical expenditures are rapidly approaching 20 percent of the gross domestic product and are crowding out other priorities of national importance. The use of increasingly expensive prescription drugs is a significant part of this problem, making the cost of biopharmaceuticals a serious national concern with broad political implications. Especially with the highly visible and very large price increases for prescription drugs that have occurred in recent years, finding a way to make prescription medicinesâ€"and health care at largeâ€"more affordable for everyone has become a socioeconomic imperative. Affordability is a complex function of factors, including not just the prices of the drugs themselves, but also the details of an individual's insurance coverage and the number of medical conditions that an individual or family confronts. Therefore, any solution to the affordability issue will require considering all of these factors together. The current high and increasing costs of prescription drugsâ€"coupled with the broader trends in overall health care costsâ€"is unsustainable to society as a whole. Making Medicines Affordable examines patient access to affordable and effective therapies, with emphasis on drug pricing, inflation in the cost of drugs, and insurance design. This report explores structural and policy factors influencing drug pricing, drug access programs, the emerging role of comparative effectiveness assessments in payment policies, changing finances of medical practice with regard to drug costs and reimbursement, and measures to prevent drug shortages and foster continued innovation in drug development. It makes recommendations for policy actions that could address drug price trends, improve patient access to affordable and effective treatments, and encourage innovations that address significant needs in health care.
Book Synopsis The Demand for Prescription Drugs as a Function of Cost-sharing by : Arleen A. Leibowitz
Download or read book The Demand for Prescription Drugs as a Function of Cost-sharing written by Arleen A. Leibowitz and published by . This book was released on 1985 with total page 40 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Book Synopsis Copayments and Demand for Medical Care by : L. Jay Helms
Download or read book Copayments and Demand for Medical Care written by L. Jay Helms and published by RAND Corporation. This book was released on 1978 with total page 52 pages. Available in PDF, EPUB and Kindle. Book excerpt: Employing a Zellner-type indirect regression technique, and data from the 1972 California Copayment Experiment, the authors attempt to assess the impact of a copayment requirement on utilization of health care resources by the poor. Focus is on three questions regarding effects of an increase in out-of-pocket cost of physician office visits: (1) Will such an increase inhibit demand for ambulatory care? (2) Will it increase or decrease demand for hospitalization? (3) How will it affect total resource cost of health care services, both in and out of hospitals? The results indicate that a $1 copayment requirement apparently decreases demand for physician visits by 8 percent and increases demand for hospital inpatient services by 17 percent. Although the confidence intervals are large, point estimates indicate that copayment increases overall program costs by a statistically insignificant 3 to 8 percent. Thus copayments could be self-defeating as a method of controlling medical costs in a welfare population.
Book Synopsis Differential Effects of Co-payment and Co-insurance on the Use and Cost of Prescription Drugs by : Ya-Seng Hsueh
Download or read book Differential Effects of Co-payment and Co-insurance on the Use and Cost of Prescription Drugs written by Ya-Seng Hsueh and published by . This book was released on 1995 with total page 430 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Book Synopsis Is Drug Coverage a Free Lunch? by : Martin Gaynor
Download or read book Is Drug Coverage a Free Lunch? written by Martin Gaynor and published by . This book was released on 2006 with total page 56 pages. Available in PDF, EPUB and Kindle. Book excerpt: "Recently, many US employers have adopted less generous prescription drug benefits. In addition, the U.S. began to offer prescription drug insurance to approximately 42 million Medicare beneficiaries in 2006. We use data on individual health insurance claims and benefit data from 1997-2003 to study the effects of changing consumers' co-payments for prescription drugs on the quantity demanded and expenditure on prescription drugs, inpatient care and outpatient care. We allow for effects both in the year of the co-payment change and in the year following the change. Our results show that increases in prescription drug prices reduce both the use of and spending on prescription drugs. However, consumers substitute the use of outpatient care and inpatient care for prescription drug use, and the expenditure reductions on prescription drugs are largely offset by the increases in other spending"--National Bureau of Economic Research web site.
Book Synopsis On Utilization and Stockpiling of Prescription Drugs when Co-payments Increase by : Niels Skipper
Download or read book On Utilization and Stockpiling of Prescription Drugs when Co-payments Increase written by Niels Skipper and published by . This book was released on 2010 with total page pages. Available in PDF, EPUB and Kindle. Book excerpt:
Book Synopsis The Demand for Prescription Drugs in Elderly Americans by : Sean Dale Sullivan
Download or read book The Demand for Prescription Drugs in Elderly Americans written by Sean Dale Sullivan and published by . This book was released on 1992 with total page 310 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Book Synopsis How Does Cost-Sharing Affect Drug Purchases? Insurance Regimes in the Private Market for Prescription Drugs by : Avi Dor
Download or read book How Does Cost-Sharing Affect Drug Purchases? Insurance Regimes in the Private Market for Prescription Drugs written by Avi Dor and published by . This book was released on 2004 with total page pages. Available in PDF, EPUB and Kindle. Book excerpt: Abstract: Insurance for prescription drugs is characterized by two types of cost-sharing: flat copayments and variable coinsurance. We develop a theoretical model to show that refill purchases of preventive drugs (compliance) are lower under coinsurance due to the consumer's exposure to variation in drug prices. Coinsurance creates countervailing incentives. Consumers who never comply under flat copayments might find it optimal to comply if they drew a relatively low price under coinsurance. In contrast, consumers who always comply under flat copayments might stop complying if they drew a relatively high price under coinsurance. Our theory shows the second effect dominates under certain distributional assumptions about health states. Empirically, we derive comparable models for compliance behavior in the two regimes. Using claims data from eight large firms, we focus our analysis on diabetes, a common chronic condition that leads to severe complications when not continuously treated with medications. Propensity score methods are used to create matched samples for the two insurance regimes. We find that when coinsurance and flat copayments have the same expected out-of-pocket of $9, at least 34% of patients under copayments would fully comply and refill their medication over the next 90 days, compared to only 24% under coinsurance. Similarly, under copayments, moving from the 25th percentile to the 75th percentile of cost sharing results in a significantly lower shift into the non-compliance state compared with coinsurance. Thus, the empirical results confirm the main theoretical predictions. This research is a substantial revision and extension of our earlier 2004 NBER working paper no. 10738.
Book Synopsis The Demand for a Medicare Prescription Drug Benefit by : Richard R. Cline
Download or read book The Demand for a Medicare Prescription Drug Benefit written by Richard R. Cline and published by . This book was released on 2001 with total page 222 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Download or read book Pharmaceutical R&D written by and published by DIANE Publishing. This book was released on 1993 with total page 380 pages. Available in PDF, EPUB and Kindle. Book excerpt: Analyzes the costs, risks, and economic rewards of pharmaceutical R&D and the impact of public policy on both costs and returns. Examines the rapid increase in pharmaceutical R&D that began in the 1980s in the light of trends in science, technology, drug discovery, and health insurance coverage; Government regulation; product liability; market competition; Federal tax policy; and Federal support of prescription drug research. 12 appendices, including a glossary of terms.
Book Synopsis Essays on the Economics of Drug Prescribing and Utilization by : Mariana Patricia Carrera
Download or read book Essays on the Economics of Drug Prescribing and Utilization written by Mariana Patricia Carrera and published by . This book was released on 2011 with total page 220 pages. Available in PDF, EPUB and Kindle. Book excerpt: Consumers do not purchase prescription drugs in a standard marketplace setting; instead, they rely on physicians to select an appropriate drug on their behalf. This potential agency problem is amplified by the fact that different consumers pay different prices for the same drug, depending on the copayments required by their insurance plan. There is a prevalent public concern that physicians are overly influenced by pharmaceutical company promotion, but little is actually known about how they choose which drugs to prescribe. This dissertation investigates the extent to which agency and information problems affect prescribing, and consequently, patient outcomes. I use individual-level data on prescription drug purchases by employees and retirees in twenty-nine Fortune 500 firms from 2003-2007 to construct a sample of patients receiving first-time prescriptions for chronic drugs. In the first two chapters, I estimate how initial prescriptions respond to three factors of patient utility: the copays set by individual health plans, large-scale copay shocks induced by patent expirations, and the predicted price-sensitivity of an individual patient. In the third chapter, a smaller sample with physician identifiers is used to measure the range of physician prescribing (number of drugs used) within a class, and its impact on patient outcomes. In Chapter 1, I study the responses of physicians and patients to variation in the cost of drugs, and assess the welfare and health consequences of asymmetric and imperfect information in the prescription drug market. I focus on statins (cholesterol-lowering drugs) which are currently the most prescribed category of prescription drugs in the United States. Demand for drugs that treat chronic conditions depends on the initial prescriptions written by a physician, and on the subsequent decisions of patients to continue the prescription or stop. I show that the continuation decision is relatively sensitive to co-payment prices. Initial prescriptions, by comparison, are relatively insensitive to co-payment prices, suggesting that physicians either don't know the prices their patients are paying, or fail to take prices into consideration. I use the event of the highly publicized expiration of the patent for Zocor (simvastatin) to test between these explanations. Insurance plans have much lower co-pays for off-patent drugs: my analysis suggests that physicians are aware of this fact, and substantially increased prescriptions for Zocor and its generic equivalents following the patent expiration. Interestingly, the increases were larger for lower-income and healthier patients, suggesting that physicians correctly perceive the adherence elasticity of their patients and adjust their initial prescriptions accordingly, but only in response to a large and universal price change. In Chapter 2, I study the prescribing responses to ten patent expirations occurring between 2004 and 2007 in four drug classes: antidepressants, statins, calcium channel blockers, and beta blockers. Four of the patent-losing drugs (including Zocor) experienced significant increases in prescribing rates, while three experienced statistically significant decreases. Understanding what drives this variation can inform how pharmaceutical advertising, health plans, and patient costs affect physician decisions. I identify two factors that explain much of the variation in these responses: the size of the copay drop upon expiration (i.e. the difference in copays of the brand and generic versions of the drug), and the current prevalence of generic prescribing in the drug class. Results suggest that physicians are more likely to increase their prescribing of a drug, after it becomes available as a generic, if it previously had a higher copay, on average. However, there is a baseline tendency to reduce prescribing of a patent-losing drug, likely driven by the cessation of its advertising, and this tendency grows stronger with the existing rate of generic prescribing in a class. In Chapter 3, which is coauthored with Geoffrey Joyce and Neeraj Sood, we measure the range of physician prescribing within the ten most prevalent therapeutic classes, the factors affecting the broadness of this range, and its impact on patient outcomes. Physicians prescribe more broadly than commonly perceived. In 8 of 10 classes, the median physician prescribes at least 3 different drugs despite the small number of initial prescriptions observed per doctor (median=7). Physicians treating patients with a greater range of comorbid conditions and varied formulary designs prescribe a broader range of drugs within a class. Though narrow prescribers are more likely to prescribe highly advertised drugs, few physicians prescribe these drugs exclusively. Narrow prescribing has modest effects on medication adherence and out of pocket costs in some drug classes.
Book Synopsis Frequency and Magnitude of Co-payments Exceeding Prescription Drug Cost by : Ki Jin Jeun
Download or read book Frequency and Magnitude of Co-payments Exceeding Prescription Drug Cost written by Ki Jin Jeun and published by . This book was released on 2019 with total page 39 pages. Available in PDF, EPUB and Kindle. Book excerpt: Objective: To investigate the healthcare expenditure in prescription drug and analyze the frequency and the magnitude of overpayments in prescription drug. Methods: Data from the 2016 Medical Expenditure Panel Survey was analyzed. Survey respondents of top ten most commonly prescribed drugs in 2016 were included in the study. Data from National Average Drug Acquisition Cost was used to identify the unit price of the prescription drugs. As NADAC changed quarterly, the average was calculated. The NDC and drug strength was used to verify the unit price with corresponding drug. The equation used to calculate estimated cash price of drug was: (Quantity dispensed x Unit Price) + Profit Margin + Dispensing Fee. Two scenarios were constructed accounting different dispensing fee - a higher and a lower. The calculated value was compared to the self OOP value reported in MEPS to determine overpaid cases. Results: With lower-end dispensing fee accounted, 29.23% of cases involved overpayment overall, with average magnitude of $8.14. With higher-end dispensing fee accounted, 6.61% of cases involved overpayment, with average magnitude of $14.59. Conclusion: Patients' OOP cost exceed acceptable limits very frequently despite use of insurance for very commonly used generic medications. Benefit designs need to be modified and pharmacists need to look for cost saving opportunities for patients.
Book Synopsis The Effects of Coinsurance on the Demand for Prescription Drugs by : John J. Jr Kent
Download or read book The Effects of Coinsurance on the Demand for Prescription Drugs written by John J. Jr Kent and published by . This book was released on 1977 with total page 142 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Book Synopsis Greater Access to Generic Drugs by : Michelle Meadows
Download or read book Greater Access to Generic Drugs written by Michelle Meadows and published by . This book was released on 2003 with total page 8 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Book Synopsis Tracking Universal Health Coverage by : World Health Organization
Download or read book Tracking Universal Health Coverage written by World Health Organization and published by World Health Organization. This book was released on 2015-07-21 with total page 98 pages. Available in PDF, EPUB and Kindle. Book excerpt: This report is the first of its kind to measure health service coverage and financial protection to assess countries' progress towards universal health coverage. It shows that at least 400 million people do not have access to one or more essential health services and 6% of people in low- and middle-income countries are tipped into or pushed further into extreme poverty because of health spending. Universal health coverage (UHC) means that all people receive the quality essential health services they need without being exposed to financial hardship. A significant number of countries at all levels of development are embracing the goal of UHC as the right thing to do for their citizens. It is a powerful social equalizer and contributes to social cohesion and stability. Every country has the potential to improve the performance of its health system in the main dimensions of UHC: coverage of quality services and financial protection for all. Priorities strategies and implementation plans for UHC will differ from one country to another. Enhanced and expanded monitoring of health under the Sustainable Development Goals (SDGs) should seek to build on that experience sharpening our focus on the key health service and financial protection interventions that underpin UHC. Effective UHC tracking is central to achieving the global goals for poverty alleviation and health improvement set by the World Bank Group and WHO. Without it policymakers and decision-takers cannot say exactly where they are or set a course for where they want to go. They cannot know whether they are focussing their efforts in the right areas or whether their efforts are making a difference. Monitoring is thus fundamental to the achievement of UHC objectives. It will also be vital to the realization of the SDGs. This report is a critical step to show how monitoring progress can be done telling us what the state of coverage of interventions and financial protection is and telling us where to focus most.
Book Synopsis Does Cost-effectiveness Analysis Have a Role in US Managed Care Drug Formularies? : an Empirical Study of Utilization, Costs, Outcomes, and Elasticity of Demand of a Value-based Formulary by : Kai Yeung
Download or read book Does Cost-effectiveness Analysis Have a Role in US Managed Care Drug Formularies? : an Empirical Study of Utilization, Costs, Outcomes, and Elasticity of Demand of a Value-based Formulary written by Kai Yeung and published by . This book was released on 2015 with total page 51 pages. Available in PDF, EPUB and Kindle. Book excerpt: The standard economic model for health insurance posits that in order to account for moral hazard in a population for which there is varying marginal benefit of treatment that is unknown to the insurer, cost-sharing should be proportional to the price elasticity of demand. Yet, many have observed that when faced with cost-sharing, consumers may reduce utilization to suboptimal levels due to underestimation of the marginal benefit of treatment. Hence, optimal health insurance design requires consideration of both insurer and consumer information asymmetries regarding the marginal benefits of treatment. This dissertation investigates whether cost-effectiveness analysis (CEA) may be useful for optimizing insurance in the face of insurer and consumer information asymmetries. In 2010, Premera Blue Cross, a large non-profit health plan in the Pacific Northwest implemented a value based formulary (VBF) benefit among their own employees and dependents that explicitly uses CEA to inform medication placement within copayment tiers. We exploit this natural experiment to empirically assess the impact of the VBF on medication utilization and other health services utilization and the impact of the VBF on medication costs and non-medication costs from the member, health plan, and overall perspectives. We also estimate price elasticities of demand for pharmaceuticals overall, by therapeutic class, by brand-generic status, and finally by the copayment tiers informed by CEA. In the first paper, we use individual-level data from July 2006 to June 2013 drawn from the employees of Premera and their dependents as well as data from employees and dependents of 5 employer sponsored plans administrated by Premera and chosen based on similarity to the intervention group in industry classification. After controlling for member demographics and plan characteristics and secular trends using an interrupted time series design with concurrent control, we find that the VBF shifted member medication utilization towards drugs placed in lower copayment tiers. The VBF also was associated with increased member medication costs and decreased health plan medication costs, leading to a net medication savings of $8 per member per month (PMPM) (95% confidence interval [CI], -$15, -$2). Over the 3 year period of the study, the medication cost savings totaled over $1.1 million USD. The findings regarding non-medication costs were comparatively small and not statistically significant. Total costs decreased by $9 PMPM (95% CI, -$49, $30) but was not statistically significant. We did not detect any changes in the probability or the number of emergency department visits, hospitalizations, or office visits. This evaluation suggests that the VBF may have reduced overall medication costs without negatively impacting utilization of other health services – a proxy for adverse outcomes. In the second paper, we use data from July 2009 to June 2011 drawn from the employees of Premera and their dependents to construct a medication level dataset of 284 unique medications. These medications accounted for 79.3% of the prescription medication volume over the period of observation. After controlling for member demographics and using a pre-post design, we find that our elasticity estimates of -0.14 for the probability of filling a medication were similar to the overall elasticity estimates of -0.17 from the RAND Health Insurance Experiment. We also find that the estimates by therapeutic class and brand-generic status also were generally similar to published studies. Finally, we estimate of price elasticity of demand by copayment tiers informed by CEA. We found that elasticity estimates for the probability of fill and days’ supply of medication respectively were -0.07 and -0.06 for the preventive tier, -0.09 and 0.08 for tier 1, -0.26 and -0.26 for tier 2, -0.27 and -0.32 for tier 3, and -0.45 and -0.55 for tier 4. Thus we observed a general trend of increasing elasticity with increasing copayment tiers. These results suggest that a cost sharing strategy based on elasticity estimates may be similar to a cost sharing strategy informed by CEA. Furthermore, since in the first paper we observed that the VBF was associated with decreased medication costs without negatively impacting health services utilization, we suggest that the use of CEA to inform medication copayment tiers may have a role in optimizing insurance benefit design. Contemporaneous with the implementation of the VBF on July 2010, the US health insurance market has experienced many changes. The passage of the Patient Protection and Affordable Care Act (PPACA) in March 2010 and the progressive implementation of many provisions in that law have fundamentally altered the insurance and provider markets. One provision in PPACA explicitly supports the development of value-based insurance design. This provision has led to the promulgation of federal regulations that have focused on eliminating cost-sharing for certain preventive services. The PPACA also has mandated coverage of preventive services recommended by Advisory Committee on Immunization Practices and the US Preventive Services Task Force. Due to the direct influence these national advisory bodies now have on the coverage of preventive services, others have advocated use of CEA by these bodies to inform the relative costs and benefits of their decisions. Our research suggests that the application of CEA to explicitly inform cost-sharing may allow the expansion of value-based principles beyond waivers of cost-sharing for specific “high value” services. Another important provision of PPACA is the formation of Accountable Care Organizations (ACOs) by health care providers that are accountable for the quality, cost, and overall care of Medicare beneficiaries. Under this provision, the ACOs enter into payment contracts that share both financial risk and savings for the care of beneficiaries. This shift in financial risk may cause ACOs to become more aware of the cost of health care. Further, since providers can greatly influence medications utilization behavior, ACOs may become an important lever for the introduction of value-based principles in integrated delivery system models. Finally, PPACA and the Health Information Technology for Economic and Clinical Health Act of 2009 have financially incentivized the use of electronic health records (EHR). It is possible that future iterations of VBFs could utilize patient-level information from EHRs to more accurately triangulate levels of cost-sharing with better estimates of treatment benefit. Further, the adoption of electronic health records may allow for future evaluations of VBFs that are able to assess true health outcomes. In sum, changes in the health insurance market present many opportunities and challenges for the adoption and evaluation of value-based principles in health insurance design. Policymakers and researchers should carefully assess such dynamics when considering the role of value-based insurance in health insurance markets in the future. Footnote: A joint regulation issued by the Department of Health and Human Services, the Internal Revenue Service and the Department of Labor, regarding the elimination copayments for certain preventive services states “The Departments recognize the important role that value-based insurance design can play in promoting the use of appropriate preventive services.”
