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.

项目摘要 该研究建议评估医师支付阳光法（PPSA）的早期影响，这是一个 负担得起的护理法案规定，需要公开披露医疗产品的付款 从2013年8月开始，包括制药公司在内的医师在内的制造商。 该建议是为了理解我们如何披露财务关系的理解 医师和制药行业影响医疗保健负担能力，效率和成本透明度。 该研究具有以下具体目的：1）确定PPSA对和和 两种药物的处方药支出：他汀类药物和抗精神病药； 2）确定 PPSA用于利用和分别用于具有和没有通用等效物的品牌药物的支出 以及每个班级的仿制药； 3）检查医生对PPSA影响的异质性 专业，PPSA之前的处方数量以及制药公司的付款。 我们建议分析包含医疗和药房索赔的医疗保健成本研究所的数据 三名国家保险公司覆盖5000万个人。我们的准实验研究设计利用了事实 马萨诸塞州和佛蒙特州的两个州实施了自己的公开披露立法 2013年之前的PPSA。我们将使用MA和VT采用差异差异和事件研究方法 作为对照组。我们的治疗组包括剩下的六个东北州而没有报告 在PPSA之前进行任务。因此，我们的研究设计使我们能够估计利用率的差异 以及在商业保险中实施PPSA之前的支出措施与实施PPSA之后 治疗状态相对于对照状态的患者。 预计拟议的研究将为有效性提供最初的严格证据之一 PPSA提高处方药提供的效率和负担能力以及 这种影响的基本机制。它还将阐明 ppsa。它将提供及时，关键的信息以及旨在遏制的进一步立法努力 制药公司与医生之间的财务关系。