Benefit Plan Design and Prescription Drug Utilization Among Asthmatics: Do Patient Copayments Matter?

Verfasser / Beitragende:
[William H. Crown, Ernst R. Berndt, Onur Baser, Stan N. Finkelstein, Whitney P. Witt, Jonathan Maguire, Kenan E. Haver]
Ort, Verlag, Jahr:
2004
Enthalten in:
Forum for Health Economics & Policy, 7/1(2004-01-01)
Format:
Artikel (online)
ID: 378931768
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245 0 0 |a Benefit Plan Design and Prescription Drug Utilization Among Asthmatics: Do Patient Copayments Matter?  |h [Elektronische Daten]  |c [William H. Crown, Ernst R. Berndt, Onur Baser, Stan N. Finkelstein, Whitney P. Witt, Jonathan Maguire, Kenan E. Haver] 
520 3 |a The ratio of controller-to-reliever medication use has been proposed as a measure of treatment quality for asthma patients. In this study we examine the effects of plan-level mean out-of-pocket asthma medication patient copayments and other features of benefit plan design on the use of controller medications alone, controller and reliever medications (combination therapy), and reliever medications alone. The 1995–2000 MarketScanTM claims data were used to construct plan-level out-of-pocket copayment and physician/practice prescriber preference variables for asthma medications. Separate multinomial logit models were estimated for patients in fee-for-service (FFS) and non-FFS plans relating benefit plan design features, physician/practice prescribing preferences, patient demographics, patient comorbidities, and county-level income variables to patient-level asthma treatment patterns. We find that the controller-to-reliever ratio rose steadily over 1995–2000, along with out-of-pocket payments for asthma medications, which rose more for controllers than for relievers. After controlling for other variables, however, plan-level mean out-of-pocket copayments were not found to have a statistically significant influence on patient-level asthma treatment patterns. On the other hand, physician/practice prescribing patterns strongly influenced patient-level treatment patterns. There is no strong statistical evidence that higher levels of out-of-pocket copayments for prescription drugs influence asthma treatment patterns. However, physician/practice prescribing preferences influence patient treatment. 
540 |a ©2011 Walter de Gruyter GmbH & Co. KG, Berlin/Boston 
700 1 |a Crown  |D William H.  |u Medstat  |4 aut 
700 1 |a Berndt  |D Ernst R.  |u MIT Sloan School and NBER  |4 aut 
700 1 |a Baser  |D Onur  |u Medstat  |4 aut 
700 1 |a Finkelstein  |D Stan N.  |u MIT Sloan School  |4 aut 
700 1 |a Witt  |D Whitney P.  |u Northwestern University  |4 aut 
700 1 |a Maguire  |D Jonathan  |u Medstat  |4 aut 
700 1 |a Haver  |D Kenan E.  |u Massachusetts General Hospital  |4 aut 
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950 |B NATIONALLICENCE  |P 700  |E 1-  |a Berndt  |D Ernst R.  |u MIT Sloan School and NBER  |4 aut 
950 |B NATIONALLICENCE  |P 700  |E 1-  |a Baser  |D Onur  |u Medstat  |4 aut 
950 |B NATIONALLICENCE  |P 700  |E 1-  |a Finkelstein  |D Stan N.  |u MIT Sloan School  |4 aut 
950 |B NATIONALLICENCE  |P 700  |E 1-  |a Witt  |D Whitney P.  |u Northwestern University  |4 aut 
950 |B NATIONALLICENCE  |P 700  |E 1-  |a Maguire  |D Jonathan  |u Medstat  |4 aut 
950 |B NATIONALLICENCE  |P 700  |E 1-  |a Haver  |D Kenan E.  |u Massachusetts General Hospital  |4 aut 
950 |B NATIONALLICENCE  |P 773  |E 0-  |t Forum for Health Economics & Policy  |d De Gruyter  |g 7/1(2004-01-01)  |q 7:1  |1 2004  |2 7  |o fhep 
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