Nonlinear pricing in drug benefits and medication use: the case of statin compliance in Medicare Part D.
Nonlinear pricing in drug benefits and medication use: the case of statin compliance in Medicare Part D.
复制标题
药物福利和药物使用的非线性定价：医疗保险 D 部分中他汀类药物合规性的案例。
作者：
Kyoungrae Jung;R. Feldman;A. McBean
目的
为了研究参保者的他汀类药物依从性如何对医疗保险D部分的预期价格做出反应，该部分的特点是由于覆盖范围差距而导致的非线性价格表。
数据来源/研究环境
处方药事件数据为2008年医疗保险优势处方药计划登记者中5%的随机样本，他们没有获得低收入补贴。
研究设计
我们分析了他汀类药物在覆盖缺口之前的依从性，其中“有效价格”高于药物的实际自付费用，因为消费者预计更多的支出将使他们更有可能达到差距。我们构造每个参与者的有效价格作为她在年底的预期价格，这是缺口前和缺口内共付额之间的加权平均值，权重是达到差距的预测概率。合规性被定义为至少80%的天数。
主要调查结果
D部分登记者的前间隙他汀类药物依从性下降3.7-4.7个百分点，有效价格增加10美元。
结论
覆盖缺口的存在降低了他汀类药物的依从性之前的差距，这表明，将预期的未来价格是重要的，以评估非线性价格表下的药物依从性的成本分担的全面影响。
OBJECTIVE
To examine how enrollees' statin compliance responds to expected prices in Medicare Part D, which features a nonlinear price schedule due to a coverage gap.
DATA SOURCES/STUDY SETTING
Prescription Drug Event data for a 5 percent random sample of Medicare Advantage Prescription Drug Plan enrollees in 2008 who did not receive a low-income subsidy.
STUDY DESIGN
We analyze statin compliance prior to the coverage gap, where the "effective price" is higher than the actual copayment for drugs because consumers anticipate that more spending will make them more likely to reach the gap. We construct each enrollee's effective price as her expected price at the end of the year, which is the weighted average between pre-gap and in-gap copayments with the weight being the predicted probability of hitting the gap. Compliance is defined as at least 80 percent of days covered.
PRINCIPAL FINDINGS
Part D enrollees' pre-gap statin compliance decreases by 3.7-4.7 percentage points for a $10 increase in the effective price.
CONCLUSION
The presence of a coverage gap decreases statin compliance prior to the gap, suggesting that incorporating expected future prices is important to assess the full impact of cost sharing on drug compliance under nonlinear price schedules.
登录
查看更多内容
影响因子：
3.2
作者：
Antônio Jaeger;Raquel Eloísa Eisenkraemer;L. Stein
通讯作者：
Antônio Jaeger;Raquel Eloísa Eisenkraemer;L. Stein
陷入承保缺口：D 部分药品费用以及患有糖尿病的 Medicare Advantage 处方药计划受益人的遵守情况。
影响因子：
3.4
作者：
Fung,Vicki;Mangione,CarolM;Huang,Jie;Turk,Norman;Quiter,ElaineS;Schmittdiel,JulieA;Hsu,John
通讯作者：
Hsu,John
药物依从性和仿制药疗法的使用。
DOI：
--
发表时间：
2009
期刊：
The American journal of managed care
影响因子：
--
作者：
Briesacher,BeckyA;Andrade,SusanE;Fouayzi,Hassan;Chan,KArnold
通讯作者：
Chan,KArnold
不同临床状态的药学益处：以降胆固醇治疗为例。
DOI：
--
发表时间：
2006
期刊：
The American journal of managed care.
影响因子：
--
作者：
Goldman,DanaP;Joyce,GeoffreyF;Karaca-Mandic,Pinar
通讯作者：
Karaca-Mandic,Pinar