Prescription drug co-payments and cost-related medication underuse
Prescription drug co-payments and cost-related medication underuse
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DOI：
10.1017/s1744133107004380
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发表时间：
2008-01-01
影响因子：
1.7
通讯作者：
Piette, John D.
中科院分区：
文献类型：
--
作者：
Wagner, Todd H.;Heisler, Michele;Piette, John D.
共同支付与过去五年医药支出增长放缓有关。然而，有健康问题的病人往往难以负担药物治疗费用，也不能按规定服药。我们研究了共同支付金额与四种与成本相关的使用不足之间的关系：服用较少剂量，推迟服用药物，根本不按处方服药，以及服用药物的频率低于处方。我们对美国50岁及以上的成年人进行了一项全国性的调查，他们都在服用慢性疾病的药物。参与者提供了17种慢性疾病的信息，他们为这些疾病服用的药物，以及他们是否因费用而使用药物不足。我们分析了那些报告为他们的处方支付共同费用的人（n = 2,869）。分析涉及多变量逻辑回归，调整调查权重和聚类。我们的数据显示，共同支付与费用相关的药物使用不足之间存在强烈的正相关关系。尽管人们在药物使用不足方面有所不同，但这些行为与共同支付金额密切相关。重新调整共同支付与成本效益数据，也被称为基于价值的保险设计，值得进一步调查。
Co-payments have been linked to the slowing growth in pharmaceutical spending over the last five years. However, patients with health problems frequently have difficulty affording their pharmacotherapy and fail to take their medication as prescribed. We examine the relationship between co-payment amounts and four types of cost-related underuse: taking fewer doses, postponing taking a medication, failing to fill a prescription at all, and taking medication less frequently than prescribed. We conducted a nationwide survey of US adults age 50 and over who take medication for a chronic condition. Participants provided information on 17 chronic conditions, medication they take for those conditions, and whether they underused any medication due to cost. We analyzed those who reported paying co-payments for their prescriptions (n = 2,869). Analysis involved multivariate logistic regression, with adjustments for survey weights and clustering. Our data show a strong positive association between co-payments and cost-related medication underuse. Although people differ in how they underuse medications, these behaviours are strongly associated with co-payment amount. Realigning the co-payments with cost-effectiveness data, also known as value-based insurance design, warrants further investigation.