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Differential Effects Of Co Payment And Co Insurance On The Use And Cost Of Prescription Drugs
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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 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 Does Cost Sharing Affect Compliance? by : Avi Dor
Download or read book Does Cost Sharing Affect Compliance? written by Avi Dor and published by . This book was released on 2004 with total page 28 pages. Available in PDF, EPUB and Kindle. Book excerpt: Private insurance for prescription drugs is characterized by two regimes: flat copayments and variable co-insurance. We develop a simple model to show that patient compliance is lower under coinsurance due to uncertainty in cost-sharing. Empirically, we derive comparable models for compliance behavior in the two regimes. Using claims data from nine large firms, we focus our analysis on diabetes, a common chronic condition that leads to severe complications when inappropriately treated. In the coinsurance model, an increase in the coinsurance rate from 20% to 75% resulted in the share of persons who never comply to increase by 9.9%, and reduced the share of fully compliant persons by 24.6%. In the copayment model, an increase in the copayment from $6 to $10 resulted in a 6.2% increase in the share of never-compliers, and a concomitant 9% reduction in the share of full compliers. Similar results hold when the level of cost-sharing is held constant across regimes. While non-compliance reduces expenditures on prescription drugs it may also lead to increases in indirect medical costs due to avertable complications. Using available aggregate estimates of the cost of diabetic complications, we calculate that the $6-$10 increase in copayment would have the direct effect of reducing national drug spending for diabetes by $125 million. However, the increase in non-compliance rates is expected to increase the rate of diabetic complications resulting in an additional $360 million in treatment costs. The results suggest that both private payers and public payers may be able to reduce overall medical costs by switching from coinsurance to copayments in prescription drug plans.
Book Synopsis Effects of Using Generic Drugs on Medicare's Prescription Drug Spending by : Julie Ann Somers
Download or read book Effects of Using Generic Drugs on Medicare's Prescription Drug Spending written by Julie Ann Somers and published by DIANE Publishing. This book was released on 2010 with total page 36 pages. Available in PDF, EPUB and Kindle. Book excerpt: This is a print on demand edition of a hard to find publication. Contents:(1) Overview of the Medicare Prescription Drug Benefit Program: Design of the Medicare Prescription Drug Benefit; Distribution of Spending in Medicare Part D; The Role of Private Plans in Medicare Part D; (2) Generic Drugs in Medicare Part D: Generic Substitution; Therapeutic Substitution; Comparing Potential Savings from Generic and Therapeutic Substitution; (3) Implications of Future Developments: First-Time Generic Entry; New Brand-Name Drugs; Biologics. (4) Appendix: Description of Data Used in This Analysis. Charts and tables.
Book Synopsis Care Without Coverage by : Institute of Medicine
Download or read book Care Without Coverage written by Institute of Medicine and published by National Academies Press. This book was released on 2002-06-20 with total page 213 pages. Available in PDF, EPUB and Kindle. Book excerpt: Many Americans believe that people who lack health insurance somehow get the care they really need. Care Without Coverage examines the real consequences for adults who lack health insurance. The study presents findings in the areas of prevention and screening, cancer, chronic illness, hospital-based care, and general health status. The committee looked at the consequences of being uninsured for people suffering from cancer, diabetes, HIV infection and AIDS, heart and kidney disease, mental illness, traumatic injuries, and heart attacks. It focused on the roughly 30 million-one in seven-working-age Americans without health insurance. This group does not include the population over 65 that is covered by Medicare or the nearly 10 million children who are uninsured in this country. The main findings of the report are that working-age Americans without health insurance are more likely to receive too little medical care and receive it too late; be sicker and die sooner; and receive poorer care when they are in the hospital, even for acute situations like a motor vehicle crash.
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 Cost-sharing and Drug-pricing Strategies by : Moritz Suppliet
Download or read book Cost-sharing and Drug-pricing Strategies written by Moritz Suppliet and published by . This book was released on 2016 with total page pages. Available in PDF, EPUB and Kindle. Book excerpt:
Book Synopsis Cost Sharing Cuts Employers' Drug Spending--but Employees Don't Get the Savings by :
Download or read book Cost Sharing Cuts Employers' Drug Spending--but Employees Don't Get the Savings written by and published by . This book was released on 2002 with total page 12 pages. Available in PDF, EPUB and Kindle. Book excerpt: Spending on outpatient prescription drugs has increased at double-digit rates for the past decade and is now the third largest component of health care expenses after hospital care and physician services. In an attempt to control costs, many employers and insurers have adopted incentive-based formularies, in which drugs are placed in different tiers. Under these arrangements, most drugs are covered, but enrollees have different co-payments depending on the tier to which a drug is assigned. Do increased patient cost sharing and formulary restrictions reduce pharmaceutical use and costs? To answer this question, a RAND team led by economist Geoffrey Joyce examined more than 700,000 person-years of data on beneficiaries enrolled in health plans from 25 private employers. The study is the largest ever conducted involving non-elderly patients enrolled in employer-sponsored health plans.
Book Synopsis The Effects of Consumer Co-payments in Medical Care by : Jeffrey Ralph James Richardson
Download or read book The Effects of Consumer Co-payments in Medical Care written by Jeffrey Ralph James Richardson and published by . This book was released on 1991 with total page 76 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Book Synopsis Prescription Drug Utilization by : Julie M. Ganther
Download or read book Prescription Drug Utilization written by Julie M. Ganther and published by . This book was released on 1999 with total page 622 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 Rare Diseases and Orphan Products by : Institute of Medicine
Download or read book Rare Diseases and Orphan Products written by Institute of Medicine and published by National Academies Press. This book was released on 2011-04-03 with total page 442 pages. Available in PDF, EPUB and Kindle. Book excerpt: Rare diseases collectively affect millions of Americans of all ages, but developing drugs and medical devices to prevent, diagnose, and treat these conditions is challenging. The Institute of Medicine (IOM) recommends implementing an integrated national strategy to promote rare diseases research and product development.
Download or read book The Medicare Handbook written by and published by . This book was released on 1989 with total page 48 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.
Author :National Academies of Sciences, Engineering, and Medicine Publisher :National Academies Press ISBN 13 :0309498511 Total Pages :103 pages Book Rating :4.3/5 (94 download)
Book Synopsis The Role of NIH in Drug Development Innovation and Its Impact on Patient Access by : National Academies of Sciences, Engineering, and Medicine
Download or read book The Role of NIH in Drug Development Innovation and Its Impact on Patient Access written by National Academies of Sciences, Engineering, and Medicine and published by National Academies Press. This book was released on 2020-01-27 with total page 103 pages. Available in PDF, EPUB and Kindle. Book excerpt: To explore the role of the National Institutes of Health (NIH) in innovative drug development and its impact on patient access, the Board on Health Care Services and the Board on Health Sciences Policy of the National Academies jointly hosted a public workshop on July 24â€"25, 2019, in Washington, DC. Workshop speakers and participants discussed the ways in which federal investments in biomedical research are translated into innovative therapies and considered approaches to ensure that the public has affordable access to the resulting new drugs. This publication summarizes the presentations and discussions from the workshop.
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.
