The Effect of Health Insurance on Prescription Drug Use Among Low-Income Adults:Evidence from Recent Medicaid Expansions
The Effect of Health Insurance on Prescription Drug Use Among Low-Income Adults:Evidence from Recent Medicaid Expansions
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DOI：
10.1016/j.jhealeco.2018.11.002
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发表时间：
2019-01-01
影响因子：
3.5
通讯作者：
Sommers, Benjamin D.
中科院分区：
文献类型：
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作者：
Ghosh, Ausmita;Simon, Kosali;Sommers, Benjamin D.
本研究探讨了补贴覆盖范围如何影响低收入非老年人的处方药使用。使用“平价医疗法案”的医疗补助扩展作为变化的来源和国家，所有付款人药房交易数据库，我们发现，在新医疗保险可用性的前15个月内，医疗补助支付的处方总数增加了19%，相当于每年近9个新处方，每个新注册者。我们没有发现没有保险或私人保险的处方减少的证据，这表明新的覆盖范围并没有简单地取代其他支付来源。治疗糖尿病和心脏病等疾病的药物涨幅最大，这表明慢性药物的价格弹性更大。仿制药的增加超过了名牌药物;在医疗补助药物共同支付额较高的扩张州，使用率增加较少。总体而言，这些研究结果表明，低收入人群的处方药需求表现出很大的价格敏感性，保险的扩大可以增加慢性病的药物治疗。(C)2018 Elsevier B.V.版权所有。
This study examines how subsidized coverage affects prescription drug utilization among low-income non-elderly adults. Using the Affordable Care Act's Medicaid expansions as a source of variation and a national, all-payer pharmacy transactions database, we find that within the first 15 months of new health insurance availability, aggregate Medicaid-paid prescriptions increased 19 percent, amounting to nearly 9 new prescriptions a year, per new enrollee. We find no evidence of reductions in uninsured or privately-insured prescriptions, suggesting that new coverage did not simply substitute for other payment sources. The largest increases occurred for medications treating conditions such as diabetes and heart disease, suggesting greater price elasticity for chronic medications. Generics increased more than brand-name drugs; and utilization increased less in expansion states with higher Medicaid drug copayments. Overall, these findings suggest that prescription drug demand among low-income populations exhibits substantial price sensitivity, and insurance expansion can increase medication treatment for chronic conditions. (C) 2018 Elsevier B.V. All rights reserved.