Effects of Medicare Part D coverage gap closure on utilization of branded and generic drugs.
Effects of Medicare Part D coverage gap closure on utilization of branded and generic drugs.
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DOI：
10.1002/hec.4637
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发表时间：
2023-03
期刊：
影响因子：
2.1
通讯作者：
Kaplan, Cameron M.
中科院分区：
文献类型：
--
作者：
Liu, Judith;Zhang, Yuting;Kaplan, Cameron M.
《平价医疗法案》包括一项条款，旨在逐步消除 2011 年至 2020 年间医疗保险处方药承保缺口，从而大幅降低缺口中的药品费用。使用 2007-2016 年医疗保险索赔数据，我们估计了填补缺口如何影响个人的自付费用和药物使用，分别针对品牌药和仿制药。估计政策影响的一个重要困难是，大约在同一时间，医疗保险人群常用的许多重磅药物经历了专利到期，并开始出现仿制药进入。由于仿制药条目在不同时间影响不同的治疗类别，因此我们在受益月级别按治疗类别运行双重差分模型，以将差距闭合的影响与仿制药条目的影响分开。总体而言，我们发现填补缺口大大减少了自付费用，并增加了品牌药物的使用，这些药物在分析期间的折扣率更大。达到这一差距的受益人、年龄较大或患有合并症的受益人的自付费用大幅减少。我们表明，在不考虑仿制药进入的情况下，填补药物使用覆盖范围缺口的影响对于品牌药被低估，而对于仿制药则被高估。
The Affordable Care Act included a provision to gradually eliminate the Medicare prescription drug coverage gap between 2011 and 2020, which substantially lower medication costs in the gap. Using 2007–2016 Medicare claims data, we estimate how filling the gap affects individuals’ out-of-pocket spending and medication use, separately for branded and generic drugs. One important difficulty in estimating the policy impact is that around the same time, many blockbuster drugs commonly used by the Medicare population experienced patent expiration and began to see generic entry. Because generic entries affected different therapeutic classes at different times, we run difference-in-differences models by therapeutic category at the beneficiary-month level to isolate the effect of the gap closure from that of generic entry. Overall, we find that filling the gap substantially reduced out-of-pocket spending and increased the use of branded drugs, which had larger discount rates during the analysis period. Beneficiaries reaching the gap, at older ages, or with comorbidities experienced larger reduction in out-of-pocket spending. We show that without accounting for generic entry, the effect of filling the coverage gap on medication use is underestimated for branded drugs and overestimated for generic drugs.
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DOI：
10.1162/rest_a_00518
发表时间：
2015-10
期刊：
The review of economics and statistics
影响因子：
--
作者：
Aron-Dine A;Einav L;Finkelstein A;Cullen M
通讯作者：
Cullen M
影响因子：
39.2
作者：
Li, Pengxiang;McElligott, Sean;Doshi, Jalpa A.
通讯作者：
Doshi, Jalpa A.
影响因子：
3.5
作者：
Joyce, Geoffrey F.;Zissimopoulos, Julie;Goldman, Dana P.
通讯作者：
Goldman, Dana P.
DOI：
10.1007/s10754-013-9137-2
发表时间：
2014-03-01
期刊：
INTERNATIONAL JOURNAL OF HEALTH CARE FINANCE & ECONOMICS
影响因子：
--
作者：
Jung, Kyoungrae;Feldman, Roger;McBean, A. Marshall
通讯作者：
McBean, A. Marshall
影响因子：
9.7
作者：
Aitken, Murray;Berndt, Ernst R.;Maini, Luca
通讯作者：
Maini, Luca