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Health Serv Res. Apr 1997; 32(1): 103–122.
PMCID: PMC1070172

The impact of increasing patient prescription drug cost sharing on therapeutic classes of drugs received and on the health status of elderly HMO members.

Abstract

OBJECTIVE: To assess the impact of increased prescription drug copayments on the therapeutic classes of drugs received and health status of the elderly. HYPOTHESES TESTED: Increased prescription drug copayments will reduce the relative exposure to, annual days use of, and prescription drug costs for drugs used in self-limiting conditions, but will not affect drugs used in progressive chronic conditions and will not reduce health status. STUDY DESIGN: Each year over a three-year period, one or the other of two well-insured Medicare risk groups in an HMO setting had their copayments per dispensing increased. Sample sizes ranged from 6,704 to 7,962. DATA SOURCES/DATA COLLECTION: Automated administrative data systems of the HMO were used to determine HMO eligibility, prescription drug utilization, and health status. ANALYSIS DESIGN: Analysis of variance or covariance was employed to measure change in dependent variables. FINDINGS: Relative exposure, annual days of use, and prescription drug costs for drugs used in self-limiting conditions and in progressive chronic conditions were not affected in a consistent manner across years by increases in prescription drug copayment. Health status may have been adversely affected. Larger increases in copayments appeared to generate more changes. CONCLUSIONS: Small changes in copayments did not appear to substantially affect outcomes. Large changes in copayments need further examination.

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Selected References

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  • Ash A, Porell F, Gruenberg L, Sawitz E, Beiser A. Adjusting Medicare capitation payments using prior hospitalization data. Health Care Financ Rev. 1989 Summer;10(4):17–29. [PubMed]
  • Foxman B, Valdez RB, Lohr KN, Goldberg GA, Newhouse JP, Brook RH. The effect of cost sharing on the use of antibiotics in ambulatory care: results from a population-based randomized controlled trial. J Chronic Dis. 1987;40(5):429–437. [PubMed]
  • Greenlick MR, Darsky BJ. A comparison of general drug utilization in a metropolitan community with utilization under a drug prepayment plan. Am J Public Health Nations Health. 1968 Nov;58(11):2121–2136. [PMC free article] [PubMed]
  • Guralnik JM, Yanagishita M, Schneider EL. Projecting the older population of the United States: lessons from the past and prospects for the future. Milbank Q. 1988;66(2):283–308. [PubMed]
  • Harris BL, Stergachis A, Ried LD. The effect of drug co-payments on utilization and cost of pharmaceuticals in a health maintenance organization. Med Care. 1990 Oct;28(10):907–917. [PubMed]
  • Johnson RE, Hornbrook MC, Nichols GA. Replicating the chronic disease score (CDS) from automated pharmacy data. J Clin Epidemiol. 1994 Oct;47(10):1191–1199. [PubMed]
  • Nelson AA, Jr, Reeder CE, Dickson WM. The effect of a Medicaid drug copayment program on the utilization and cost of prescription services. Med Care. 1984 Aug;22(8):724–736. [PubMed]
  • Ryan M, Birch S. Charging for health care: evidence on the utilisation of NHS prescribed drugs. Soc Sci Med. 1991;33(6):681–687. [PubMed]
  • Schulz RM, Lewis NJ. Payment restrictions for prescription drugs under Medicaid. Pharmacoeconomics. 1992 Mar;1(3):217–219. [PubMed]
  • Smith DG, Kirking DM. Impact of consumer fees on drug utilisation. Pharmacoeconomics. 1992 Oct;2(4):335–342. [PubMed]
  • Soumerai SB, Ross-Degnan D, Avorn J, McLaughlin T j, Choodnovskiy I. Effects of Medicaid drug-payment limits on admission to hospitals and nursing homes. N Engl J Med. 1991 Oct 10;325(15):1072–1077. [PubMed]
  • Stuart B, Ahern F, Rabatin V, Johnson A. Patterns of outpatient prescription drug use among Pennsylvania elderly. Health Care Financ Rev. 1991 Spring;12(3):61–72. [PubMed]
  • Von Korff M, Wagner EH, Saunders K. A chronic disease score from automated pharmacy data. J Clin Epidemiol. 1992 Feb;45(2):197–203. [PubMed]
  • Weeks HA. Changes in prescription drug utilization after the introduction of a prepaid drug insurance program. J Am Pharm Assoc. 1973 Apr;13(4):205–209. [PubMed]

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