caa a22 4500 378931768 CHVBK 20190511134022.0 cr unu---uuuuu 161128e20040101xx s 000 0 eng 10.2202/1558-9544.1053 doi (NATIONALLICENCE)gruyter-10.2202/1558-9544.1053 Benefit Plan Design and Prescription Drug Utilization Among Asthmatics: Do Patient Copayments Matter? [Elektronische Daten] [William H. Crown, Ernst R. Berndt, Onur Baser, Stan N. Finkelstein, Whitney P. Witt, Jonathan Maguire, Kenan E. Haver] 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. ©2011 Walter de Gruyter GmbH & Co. KG, Berlin/Boston Crown William H. Medstat aut Berndt Ernst R. MIT Sloan School and NBER aut Baser Onur Medstat aut Finkelstein Stan N. MIT Sloan School aut Witt Whitney P. Northwestern University aut Maguire Jonathan Medstat aut Haver Kenan E. Massachusetts General Hospital aut Forum for Health Economics & Policy De Gruyter 7/1(2004-01-01) 7:1 2004 7 fhep https://doi.org/10.2202/1558-9544.1053 text/html Onlinezugriff via DOI 1 research article jats NATIONALLICENCE 856 40 https://doi.org/10.2202/1558-9544.1053 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Crown William H. Medstat aut NATIONALLICENCE 700 1- Berndt Ernst R. MIT Sloan School and NBER aut NATIONALLICENCE 700 1- Baser Onur Medstat aut NATIONALLICENCE 700 1- Finkelstein Stan N. MIT Sloan School aut NATIONALLICENCE 700 1- Witt Whitney P. Northwestern University aut NATIONALLICENCE 700 1- Maguire Jonathan Medstat aut NATIONALLICENCE 700 1- Haver Kenan E. Massachusetts General Hospital aut NATIONALLICENCE 773 0- Forum for Health Economics & Policy De Gruyter 7/1(2004-01-01) 7:1 2004 7 fhep CC0 http://creativecommons.org/publicdomain/zero/1.0 nationallicence SWISSBIB 080912249 BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-gruyter