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Drug Firms Payments And Physicians Prescribing Behavior In Medicare Part D
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Book Synopsis Drug Firms' Payments and Physicians' Prescribing Behavior in Medicare Part D by : Colleen Marie Carey
Download or read book Drug Firms' Payments and Physicians' Prescribing Behavior in Medicare Part D written by Colleen Marie Carey and published by . This book was released on 2020 with total page 0 pages. Available in PDF, EPUB and Kindle. Book excerpt: In a pervasive but controversial practice, drug firms frequently make monetary or in-kind payments to physicians in the course of promoting prescription drugs. We use a federal database on the universe of such interactions between 2013 and 2015 linked to prescribing behavior in Medicare Part D. We account for the targeting of payments with fixed effects for each physician-drug combination. In an event study, we show that physicians increase prescribing of drugs for which they receive payments in the months just after payment receipt, with no evidence of differential trends between paid and unpaid physicians prior to the payment. Using hand-collected efficacy data on three major therapeutic classes, we show that those receiving payments prescribe lower-quality drugs following payment receipt, although the magnitude is small and unlikely to be clinically significant. In addition, we examine five case studies of major drugs going off patent. Physicians receiving payments from the firms experiencing the patent expiry transition their patients just as quickly to generics as physicians who do not receive such payments.
Book Synopsis Drug Firms' Payments and Physicians' Prescribing Behavior in Medicare Part D by : Colleen Marie Carey
Download or read book Drug Firms' Payments and Physicians' Prescribing Behavior in Medicare Part D written by Colleen Marie Carey and published by . This book was released on 2020 with total page 52 pages. Available in PDF, EPUB and Kindle. Book excerpt: In a pervasive but controversial practice, drug firms frequently make monetary or in-kind payments to physicians in the course of promoting prescription drugs. We use a federal database on the universe of such interactions between 2013 and 2015 linked to prescribing behavior in Medicare Part D. We account for the targeting of payments with fixed effects for each physician-drug combination. In an event study, we show that physicians increase prescribing of drugs for which they receive payments in the months just after payment receipt, with no evidence of differential trends between paid and unpaid physicians prior to the payment. Using hand-collected efficacy data on three major therapeutic classes, we show that those receiving payments prescribe lower-quality drugs following payment receipt, although the magnitude is small and unlikely to be clinically significant. In addition, we examine five case studies of major drugs going off patent. Physicians receiving payments from the firms experiencing the patent expiry transition their patients just as quickly to generics as physicians who do not receive such payments.
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 Impact of Health Insurance Expansion on Physician Treatment Choice by : Tianyan Hu
Download or read book The Impact of Health Insurance Expansion on Physician Treatment Choice written by Tianyan Hu and published by . This book was released on 2014 with total page 48 pages. Available in PDF, EPUB and Kindle. Book excerpt: We test the effect of the introduction of Medicare Part D on physician prescribing behavior by using data on physician visits from the National Ambulatory Medical Care Survey (NAMCS) 2002-2004 and 2006-2009 for patients aged 60-69. We use a combined DD-RD specification that is an improvement over either the difference-in-difference (DD) or regression discontinuity (RD) designs. Comparing the discrete jump in outcomes at age 65 before and after 2006, we find a 35% increase in the number of prescription drugs prescribed or continued per visit and a 55% increase in the number of generic drugs prescribed or continued, providing evidence of physician response to changes in patient out-of-pocket costs.
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:
Book Synopsis Competition and the Cost of Medicare's Prescription Drug Program by : Anna Cook
Download or read book Competition and the Cost of Medicare's Prescription Drug Program written by Anna Cook and published by . This book was released on 2014-09-03 with total page 48 pages. Available in PDF, EPUB and Kindle. Book excerpt: The Medicare Prescription Drug, Improvement, and Modernization Act of 2003 (the Medicare Modernization Act, or MMA) substantially expanded the federal Medicare program by creating the prescription drug benefit known as Part D. In FY 2013, Medicare Part D covered 39 million people. The federal government spent $59 billion net of premiums on Part D in that year; after accounting for certain payments from states under the program, the net federal cost was $50 billion, which represented 10% of net federal spending for Medicare. A combination of broader trends in the prescription drug market and lower-than-expected enrollment in Part D has contributed to much lower spending for the program than projected when the MMA became law in 2003. This report examines the federal budgetary cost and competitive design of Medicare Part D and compares Medicare Part D and Medicaid Fee for Service. Figures and tables. This is a print on demand report.
Book Synopsis 'Let the Sun Shine In' by : Tong Guo
Download or read book 'Let the Sun Shine In' written by Tong Guo and published by . This book was released on 2021 with total page 0 pages. Available in PDF, EPUB and Kindle. Book excerpt: U.S. pharmaceutical companies frequently pay doctors to promote their drugs. This has raised concerns about conflict of interest, which policy-makers have attempted to address by introducing payment disclosure laws. However, it is unclear if such disclosure has an effect on physician prescription behavior. We use individual-level claims data from a major provider of health insurance in the U.S. and employ a difference-in-differences research design to study the effect of the payment disclosure law introduced in Massachusetts in June 2009. The research design exploits the fact that while physicians operating in Massachusetts were impacted by the legislation, their counterparts in the neighboring states of Connecticut, New York, New Hampshire, and Rhode Island were not. In order to keep the groups of physicians comparable, we restrict our analysis to physicians in the counties that are on the border of these states. We find that the Massachusetts disclosure law resulted in a decline in prescriptions in all three drug classes studied: statins, antidepressants, and antipsychotics. Our findings are robust to alternative control groups, time periods and estimation methods. We also show that the effect is highly heterogeneous across physician groups. Finally, we explore potential mechanisms driving these results.
Book Synopsis Medicare Part D by : Office, U.s. Government Accountability
Download or read book Medicare Part D written by Office, U.s. Government Accountability and published by . This book was released on 2017-08-16 with total page 32 pages. Available in PDF, EPUB and Kindle. Book excerpt: "In 2009, GAO reported on doctor shopping in Medicaid, where individuals see several doctors and pharmacies, receiving more of a drug than was intended by any single physician. Questions have been raised about whether similar activity exists in Medicare Part D.GAO was asked to (1) determine the extent to which Medicare beneficiaries obtained frequently abused drugs from multiple prescribers, (2) identify examples of doctor shopping activity, and (3) determine the actions taken by the Centers for Medicare & Medicaid Services (CMS) to limit access to drugs for known abusers. To meet the objectives, GAO analyzed Medicare Part D claims for calendar year 2008 to identify potential doctor shoppers. To identify examples, GAO chose a nonrepresentative selection of 10 beneficiaries based on a number of factors, including the number of prescribers. GAO also interviewed policy officials from CMS and from prescription drug plans that administer the drug benefit program. GAO recommends that CMS review its findings and consider steps such as a restricted recipient program for identified doctor shoppers and seek congressional authority, as appropriate. CMS agreed with the overall recommendation to improve its efforts to curb overutilization in Part D, but disagreed that a restricted recipient program is necessarily the appropriate..."
Book Synopsis The Cost of Influence by : Melissa Newham
Download or read book The Cost of Influence written by Melissa Newham and published by . This book was released on 2023 with total page 0 pages. Available in PDF, EPUB and Kindle. Book excerpt: This paper studies how gifts - monetary or in-kind payments - from drug firms to physicians in the US affect prescriptions and drug costs. We estimate heterogeneous treatment effects by combining physician-level data on antidiabetic prescriptions and payments with causal inference and machine learning methods. We find that payments cause physicians to prescribe more brand drugs, resulting in a cost increase of $30 per dollar received. Responses differ widely across physicians, and are primarily explained by variation in patients' out-of-pocket costs. A gift ban is estimated to decrease drug costs by 3-4%. Taken together, these novel findings reveal how payments shape prescription choices and drive up costs.
Author :National Academies of Sciences, Engineering, and Medicine Publisher :National Academies Press ISBN 13 :0309459575 Total Pages :483 pages Book Rating :4.3/5 (94 download)
Book Synopsis Pain Management and the Opioid Epidemic by : National Academies of Sciences, Engineering, and Medicine
Download or read book Pain Management and the Opioid Epidemic written by National Academies of Sciences, Engineering, and Medicine and published by National Academies Press. This book was released on 2017-09-28 with total page 483 pages. Available in PDF, EPUB and Kindle. Book excerpt: Drug overdose, driven largely by overdose related to the use of opioids, is now the leading cause of unintentional injury death in the United States. The ongoing opioid crisis lies at the intersection of two public health challenges: reducing the burden of suffering from pain and containing the rising toll of the harms that can arise from the use of opioid medications. Chronic pain and opioid use disorder both represent complex human conditions affecting millions of Americans and causing untold disability and loss of function. In the context of the growing opioid problem, the U.S. Food and Drug Administration (FDA) launched an Opioids Action Plan in early 2016. As part of this plan, the FDA asked the National Academies of Sciences, Engineering, and Medicine to convene a committee to update the state of the science on pain research, care, and education and to identify actions the FDA and others can take to respond to the opioid epidemic, with a particular focus on informing FDA's development of a formal method for incorporating individual and societal considerations into its risk-benefit framework for opioid approval and monitoring.
Book Synopsis Exploration of Variation of Prescribing by : Yu Wang
Download or read book Exploration of Variation of Prescribing written by Yu Wang and published by . This book was released on 2019 with total page 182 pages. Available in PDF, EPUB and Kindle. Book excerpt: Healthcare spending in the United States has been among the highest of all countries worldwide. One of the big elements of patient care is prescribing. Prescribing cost has been increasing in the United States for the past ten years and reached $329 billion in 2016. Thus, it is important to understand what medications prescribers are relying on in order to potentially decrease the growth rate of prescription cost of the United States. A sequential explanatory mixed methods study with the focus of exploring the existence of "small individual formulary" phenomenon and a retrospective cross-sectional data analysis were conducted. The mixed methods study was conducted in two phases with the first phase being secondary data analysis using 2015 Medicare prescriber utilization and payment data for Part D prescribers. Prescription medications were ranked in descending order by the number of claims associated with a specific medication. Prescribing breadth was reflected by the number of prescriptions which accounted for the top 80% of total claims. Concentration, or the frequency of prescribing of each drug, was measured by Herfindahl-Hirschman Index (HHI). The second phase of the mixed method study was 11 semi-structured interviews with active prescribers with the focus on prescribing decision making. he retrospective cross-sectional data analysis employed the 2015 National Ambulatory Medical Care Survey (NAMCS) data. Variation in prescribing was measured using HHI and the number of unique prescriptions identified from all patient visits of each physician. The prescribing behavior was categorized as concentrated when the HHI index was greater than or equal to 1500. Logistic and Poisson regressions, weighted by survey physician weights, were conducted at the physician level to identify significant factors of variation in prescribing. The first phase of mixed method study included a total of 651,736 prescribers, whose results, alongside the results of the second phase, suggest that prescribers rely on a limited number of guideline-recommended cheap medications in regular practice. The number of visits associated with the physician, the ability of the practice to record patients' medications and allergies, the ability of the practice to reconcile medication list were significantly associated with variation in prescribing.
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 Prescription Drug Advertising and Drug Utilization by : Abby Alpert
Download or read book Prescription Drug Advertising and Drug Utilization written by Abby Alpert and published by . This book was released on 2015 with total page 66 pages. Available in PDF, EPUB and Kindle. Book excerpt: Pharmaceutical firms currently spend over $4 billion on direct-to-consumer advertising (DTCA) of prescription drugs, a nearly 30-fold increase since 1993 that has led to much debate about its value to patients. We examine how DTCA influences drug utilization along the extensive and intensive margins by exploiting a large and plausibly exogenous shock to DTCA driven by the introduction of Medicare Part D in 2006. Using data on advertising for local media markets from Nielsen, we show that Part D led to large relative increases in DTCA in geographic areas with a high concentration of Medicare beneficiaries compared to areas with a low concentration. We examine the effects of this sudden differential increase in advertising on non-elderly individuals to isolate the effects of advertising on drug utilization from the direct effects of Part D. Using data from pharmacy claims, we find substantial differential increases in drug utilization that mirror the increases in DTCA after Part D. These effects are driven both by increased take-up of treatment and improved drug adherence. Our results imply significant spillovers from Medicare Part D onto the under-65 population and an important role for non-price factors in influencing prescription drug utilization.
Author :United States. Social Security Administration. Office of Research and Statistics Publisher : ISBN 13 : Total Pages :84 pages Book Rating :4.:/5 (31 download)
Book Synopsis The Impact of Medicare by : United States. Social Security Administration. Office of Research and Statistics
Download or read book The Impact of Medicare written by United States. Social Security Administration. Office of Research and Statistics and published by . This book was released on 1970 with total page 84 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Book Synopsis Conflict of Interest in Medical Research, Education, and Practice by : Institute of Medicine
Download or read book Conflict of Interest in Medical Research, Education, and Practice written by Institute of Medicine and published by National Academies Press. This book was released on 2009-09-16 with total page 436 pages. Available in PDF, EPUB and Kindle. Book excerpt: Collaborations of physicians and researchers with industry can provide valuable benefits to society, particularly in the translation of basic scientific discoveries to new therapies and products. Recent reports and news stories have, however, documented disturbing examples of relationships and practices that put at risk the integrity of medical research, the objectivity of professional education, the quality of patient care, the soundness of clinical practice guidelines, and the public's trust in medicine. Conflict of Interest in Medical Research, Education, and Practice provides a comprehensive look at conflict of interest in medicine. It offers principles to inform the design of policies to identify, limit, and manage conflicts of interest without damaging constructive collaboration with industry. It calls for both short-term actions and long-term commitments by institutions and individuals, including leaders of academic medical centers, professional societies, patient advocacy groups, government agencies, and drug, device, and pharmaceutical companies. Failure of the medical community to take convincing action on conflicts of interest invites additional legislative or regulatory measures that may be overly broad or unduly burdensome. Conflict of Interest in Medical Research, Education, and Practice makes several recommendations for strengthening conflict of interest policies and curbing relationships that create risks with little benefit. The book will serve as an invaluable resource for individuals and organizations committed to high ethical standards in all realms of medicine.
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 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:
