Impact of the Physician Payments Sunshine Act on Prescription Drug Utilization and Spending

医生支付阳光法案对处方药使用和支出的影响

• 批准号: 9807060
• 负责人: Jing Li
• 金额: $ 9.99万
• 依托单位: WEILL MEDICAL COLL OF CORNELL UNIV
• 依托单位国家: 美国
• 财政年份: 2019
• 资助国家: 美国
• 起止时间: 2019-07-01 至 2020-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9807060
• 关键词: Impact; Physician; Payments; Sunshine; Act

PROJECT SUMMARY The study proposes to evaluate the early impact of the Physician Payments Sunshine Act (PPSA), an Affordable Care Act provision that requires public disclosure of payments made from medical product manufacturers, including pharmaceutical companies, to physicians starting August 2013. The long-term goal of this proposal is to contribute to our understanding of how disclosure of financial relationships between physicians and the pharmaceutical industry impacts healthcare affordability, efficiency and cost transparency. The study has the following specific aims: 1) determine the effects of the PPSA on overall utilization of and spending on prescription drugs in the two drug classes: statins and antipsychotics; 2) determine the effects of the PPSA on utilization and spending separately for brand-name drugs with and without generic equivalents as well as generic drugs in each class; 3) examine heterogeneity in the effects of the PPSA by physician specialty, prescribing volume in the pre-PPSA period, and payment from pharmaceutical companies. We propose to analyze data from Health Care Cost Institute containing medical and pharmacy claims from three national insurers covering 50 million individuals. Our quasi-experimental research design exploits the fact that two states, Massachusetts and Vermont, implemented their own public disclosure legislations similar to the PPSA before 2013. We will employ difference-in-difference and event study approaches, using MA and VT as the control group. Our treatment group includes six of the remaining Northeastern states without reporting mandates prior to the PPSA. Therefore, our research design allows us to estimate the differences in utilization and spending measures before versus after the implementation of the PPSA among commercially insured patients in the treatment states relative to the control states. The proposed research is expected to provide one of the first pieces of rigorous evidence on the effectiveness of the PPSA in improving the efficiency and affordability of prescription drug provision, as well as the underlying mechanism of such effects. It will also shed light on potential unintended consequences of the PPSA. It will provide timely and critical information as well as further legislative efforts aimed at curbing financial relationships between pharmaceutical companies and physicians.

项目总结 该研究建议评估医生支付阳光法案(PPSA)的早期影响，以及 《平价医疗法案》规定，要求公开披露医疗产品的付款情况 从2013年8月开始，包括制药公司在内的制造商向医生开放。的长期目标是 这项建议旨在帮助我们理解披露财务关系是如何 医生和制药业影响医疗负担能力、效率和成本透明度。 这项研究有以下具体目的：1)确定PPSA对总使用率的影响 两种药物类别的处方药支出：他汀类和抗精神病药物；2)决定 含仿制等价物和不含仿制等价物的品牌药品单独使用和支出情况 以及每个类别的仿制药；3)由医生检查PPSA效果的异质性 专科，PPSA前的处方数量，以及制药公司的付款。 我们建议分析来自Health Care Cost Institute的数据，其中包含来自 覆盖5000万个人的三家全国性保险公司。我们的准实验研究设计利用了这样一个事实 两个州，马萨诸塞州和佛蒙特州，实施了自己的公开披露立法，类似于 2013年前的PPSA。我们将使用差异法和事件研究法，使用MA和VT 作为对照组。我们的治疗小组包括东北部剩余的六个州，但没有报告 在PPSA之前的任务。因此，我们的研究设计允许我们估计利用率的差异 以及商业保险实施PPSA前后的支出措施 处于治疗状态的患者相对于对照状态。 这项拟议中的研究预计将提供关于有效性的第一批严格证据之一。 PPSA在提高处方药供应的效率和负担能力方面的作用，以及 这种影响的潜在机制。它还将揭示经济衰退可能带来的意外后果 PPSA。它将提供及时和关键的信息以及进一步的立法努力，旨在遏制 制药公司和医生之间的财务关系。