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Adherence to beta-blocker therapy under drug cost-sharing in patients with and without acute myocardial infarction.

https://arctichealth.org/en/permalink/ahliterature162000
Source
Am J Manag Care. 2007 Aug;13(8):445-52
Publication Type
Article
Date
Aug-2007
Author
Sebastian Schneeweiss
Amanda R Patrick
Malcolm Maclure
Colin R Dormuth
Robert J Glynn
Author Affiliation
Division of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, 1620 Tremont St (Ste 3030), Boston, MA 02120, USA. schneeweiss@post.harvard.edu
Source
Am J Manag Care. 2007 Aug;13(8):445-52
Date
Aug-2007
Language
English
Publication Type
Article
Keywords
Acute Disease
Adrenergic beta-Antagonists - economics - therapeutic use
Aged
Aged, 80 and over
British Columbia
Case-Control Studies
Cohort Studies
Comorbidity
Cost Sharing
Deductibles and Coinsurance
Diabetes Complications
Female
Health Policy - trends
Humans
Male
Medical Record Linkage
Myocardial Infarction - drug therapy - economics
Patient Compliance - statistics & numerical data
Prescription Fees
Vascular Diseases
Abstract
To evaluate the effects of patient copayment and coinsurance policies on adherence to therapy with beta-adrenergic blocking agents (beta-blockers) and on the rate of initiation of beta-blocker therapy after acute myocardial infarction (MI) in a population-based natural experiment.
Three sequential cohorts included British Columbia residents age 66 years and older who initiated beta-blocker therapy during time intervals with full drug coverage (2001), a $10 or $25 copayment (2002), and 25% coinsurance (2003-2004). We used linked data on all prescription drug dispensings, physician services, and hospitalizations. Follow-up of each cohort was 9 months after the policy changes.
We measured the proportion of subjects in each cohort who were adherent to beta-blocker therapy over time, with adherence defined as having >80% of days covered. We also measured the proportion of patients initiating beta-blocker therapy after acute MI. Policy effects were evaluated using multivariable regression.
Adherence to beta-blocker therapy was marginally reduced as a consequence of the copayment policy (-1.3 percentage points, 95% confidence interval [CI] = -2.5 , -0.04) or the coinsurance policy (-0.8 percentage points, 95% CI = -2.0, 0.3). The proportion of patients initiating beta-blockers after hospitalization for acute MI remained steady at about 61% during the study period, similar to that observed in a control population of elderly Pennsylvania residents with full drug coverage.
Fixed patient copayment and coinsurance policies had little negative effect on adherence to relatively inexpensive beta-blocker therapy, or initiation of beta-blockers after acute MI.
Notes
Cites: N Engl J Med. 1991 Oct 10;325(15):1072-71891009
Cites: J Chronic Dis. 1987;40(5):373-833558716
Cites: J Hypertens Suppl. 1993 Jun;11(4):S61-738104243
Cites: Arch Intern Med. 1995 Apr 10;155(7):701-97695458
Cites: Pharmacoeconomics. 1996;10 Suppl 2:37-4710163434
Cites: JAMA. 1997 Jan 8;277(2):115-218990335
Cites: J Clin Epidemiol. 1997 Jan;50(1):105-169048695
Cites: Eur Heart J. 1998 Oct;19(10):1434-5039820987
Cites: Lancet. 1999 Feb 20;353(9153):611-610030325
Cites: J Am Coll Cardiol. 1999 Jun;33(7):2092-19710362225
Cites: BMJ. 1999 Jun 26;318(7200):1730-710381708
Cites: Health Aff (Millwood). 2004 Jan-Jun;Suppl Web Exclusives:W4-79-9315451969
Cites: Health Aff (Millwood). 2004 Jan-Jun;Suppl Web Exclusives:W4-354-6215451957
Cites: Arch Intern Med. 2005 May 23;165(10):1147-5215911728
Cites: Health Econ. 2005 Sep;14(9):909-2316127675
Cites: Am J Manag Care. 2005 Oct;11(10):621-816232003
Cites: Clin Ther. 2006 Jun;28(6):964-78; discussion 962-316860179
Cites: Pharmacoepidemiol Drug Saf. 2006 Aug;15(8):565-74; discussion 575-716514590
Cites: Circulation. 2007 Apr 24;115(16):2128-3517420348
Cites: Lancet. 1999 Nov 20;354(9192):1751-610577635
Cites: Lancet. 2000 Dec 9;356(9246):1955-6411130523
Cites: Eur Heart J. 2001 Aug;22(16):1374-45011482917
Cites: CMAJ. 2001 Oct 16;165(8):1011-911699696
Cites: Med Care. 2001 Dec;39(12):1293-30411717571
Cites: N Engl J Med. 2002 Mar 14;346(11):822-911893794
Cites: Am J Hypertens. 1997 Jul;10(7 Pt 1):697-7049234822
Cites: Health Aff (Millwood). 2002 Mar-Apr;21(2):31-4611900185
Cites: Health Aff (Millwood). 2002 Mar-Apr;21(2):13-3011900153
Cites: BMJ. 1998 Sep 12;317(7160):703-139732337
Cites: CMAJ. 2002 Jun 25;166(13):1655-6212126319
Cites: JAMA. 2002 Jul 24-31;288(4):455-6112132975
Cites: J Clin Pharm Ther. 2002 Aug;27(4):299-30912174032
Cites: J Clin Epidemiol. 2002 Aug;55(8):833-4112384199
Cites: Clin Pharmacol Ther. 2003 Oct;74(4):388-40014534526
Cites: N Engl J Med. 2003 Dec 4;349(23):2224-3214657430
Cites: BMJ. 2004 Mar 6;328(7439):56014982865
Cites: JAMA. 2004 May 19;291(19):2344-5015150206
Cites: Med Care. 2004 Jul;42(7):653-6015213490
Cites: Am Heart J. 2004 Jul;148(1):99-10415215798
Cites: Circulation. 2004 Aug 3;110(5):588-63615289388
Cites: Health Aff (Millwood). 2004 Sep-Oct;23(5):217-2515371388
Cites: N Engl J Med. 1980 Oct 30;303(18):1038-416999345
Cites: Milbank Q. 1993;71(2):217-528510601
PubMed ID
17685825 View in PubMed
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Americans must have the right to purchase prescription drugs in Canada.

https://arctichealth.org/en/permalink/ahliterature184600
Source
Md Med. 2003;4(2):45-7
Publication Type
Article
Date
2003
Author
Bernard Sanders
Author Affiliation
Bernie@mail.house.gov
Source
Md Med. 2003;4(2):45-7
Date
2003
Language
English
Publication Type
Article
Keywords
Canada
Consumer Participation
Cost Savings
Drug Prescriptions - economics
Humans
Prescription Fees
Travel
United States
PubMed ID
12847829 View in PubMed
Less detail

[Analysis of questionnaires of patients having refused to undergo antituberculous therapy]

https://arctichealth.org/en/permalink/ahliterature69368
Source
Lik Sprava. 2002 Jul-Sep;(5-6):39-41
Publication Type
Article
Author
Iu M Valetskyi
Source
Lik Sprava. 2002 Jul-Sep;(5-6):39-41
Language
Ukrainian
Publication Type
Article
Keywords
Adolescent
Adult
Aged
Aged, 80 and over
Antitubercular Agents - economics - therapeutic use
English Abstract
Female
Humans
Male
Middle Aged
Prescription Fees
Questionnaires
Treatment Refusal - statistics & numerical data
Tuberculosis - drug therapy - economics - epidemiology
Abstract
A questionnaire survey was undertaken in those patients (n = 105) with freshly detected pulmonary tuberculosis who had refused to be treated with antituberculous therapy. The patients' reasons for refusing the above therapy was that they are not in the money to buy medicines (42.86%) and they have a distrust of existing therapies commonly applied in dealing with the medical problem under consideration (30.48%), as evidenced by the questionnaires analysis performed.
PubMed ID
12442517 View in PubMed
Less detail

An empirical note on willingness to pay and starting-point bias.

https://arctichealth.org/en/permalink/ahliterature72870
Source
Med Decis Making. 1996 Jul-Sep;16(3):242-7
Publication Type
Article
Author
N O Stålhammar
Author Affiliation
Astra Hässle AB, Mölndal, Sweden.
Source
Med Decis Making. 1996 Jul-Sep;16(3):242-7
Language
English
Publication Type
Article
Keywords
Adult
Aged
Bias (epidemiology)
Cost-Benefit Analysis
Drug Interactions
Duodenal Ulcer - drug therapy - psychology
Esophagitis, Peptic - drug therapy - psychology
Female
Financing, Personal - statistics & numerical data
Histamine H2 Antagonists - economics
Humans
Male
Middle Aged
Patient Acceptance of Health Care - statistics & numerical data
Prescription Fees
Regression Analysis
Sweden
Abstract
One of the most serious sources of potential bias when using the contingent valuation (CV) method to assess willingness to pay (WTP) is implied-value cues, i.e., different types of starting-point bias. The possible existence of starting-point bias is serious, since it may be interpreted to mean that the responders' preferences are very unstable. While the empirical evidence from environmental economics on starting-point bias is mixed, an earlier study in health economics did not find any clear evidence of starting-point bias. However, in the study presented here, a clear presence of starting-point bias was found. In a Swedish survey of how and when patients take antisecretory drugs, the patients were asked about their willingness to pay for a medication that can be taken in relation to meals compared with one that must be taken at least one hour before meals and has the additional disadvantage that it interacts with contraceptive pills. Among the 105 respondents, 82 were willing to pay a sum in addition to the normal patient fee in order to obtain the drug that could be taken during meals. The 82 patients thereafter participated in the bidding game that could start at a low bid (SEK 20) or a high bid (SEK 1,000). On average, the patients were willing to pay an additional SEK 138 (1 SEK = 0.13 U.S. dollar, April 1995) to obtain the superior drug. However, the average WTP among the 42 patients who started at the low bid was 70 SEK, which should be compared to an average of 289 SEK among the 40 patients who initially were offered the high bid.
PubMed ID
8818122 View in PubMed
Less detail

Booming prescription drug expenditure: a population-based analysis of age dynamics.

https://arctichealth.org/en/permalink/ahliterature172853
Source
Med Care. 2005 Oct;43(10):996-1008
Publication Type
Article
Date
Oct-2005
Author
Steven G Morgan
Author Affiliation
Centre for Health Services and Policy Research, Department of Health Care and Epidemiology, University of British Columbia, Vancouver, British Columbia, Canada. morgan@chspr.ubc.ca
Source
Med Care. 2005 Oct;43(10):996-1008
Date
Oct-2005
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Age Distribution
Age Factors
Aged
Aged, 80 and over
British Columbia
Child
Child, Preschool
Databases, Factual
Drug Costs - statistics & numerical data - trends
Drug Utilization - economics - statistics & numerical data - trends
Financing, Personal - statistics & numerical data - trends
Health Expenditures - statistics & numerical data - trends
Humans
Infant
Infant, Newborn
Middle Aged
Population Dynamics
Prescription Fees - statistics & numerical data - trends
Abstract
Prescription drug expenditures in North America have nearly doubled in the past 5 years, creating intense pressure for all public and private benefits managers and policymakers.
The objective of this study was to describe age-specific drug expenditure trends from 1996 to 2002 for the Canadian province of British Columbia.
This study shows changes in expenditures per capita quantified for 5 age categories: residents aged 0 to 19, 20 to 44, 45 to 64, 65 to 84, and 85 and older. The cost impacts of 7 determinants of prescription drug expenditures are quantified.
This study describes population-based, patient-specific pharmaceutical data showing the type, quantity, and cost of every prescription drug purchased by virtually all residents of British Columbia.
Population-wide expenditures per capita grew at a rate of 11.6% per annum. Growth was primarily driven by the selection of more costly drugs per course of treatment and increases in the number concomitant treatments received per patient. Population aging did not have a major impact on expenditures. However, expenditure per capita grew most rapid among residents aged 45 to 64, the cohort that expended most over the period. The aging of this demographic cohort may threaten the financial viability of age-based drug benefit programs.
PubMed ID
16166869 View in PubMed
Less detail

The Canadian Cardiovascular Society and reference-based drug pricing.

https://arctichealth.org/en/permalink/ahliterature205405
Source
Can J Cardiol. 1998 May;14(5):669-70
Publication Type
Article
Date
May-1998
Author
P M Olley
P R McLaughlin
Author Affiliation
Department of Pediatrics, University of Alberta, Edmonton. polley@peds.med.ualberta.ca
Source
Can J Cardiol. 1998 May;14(5):669-70
Date
May-1998
Language
English
Publication Type
Article
Keywords
Canada
Cardiology
Cardiovascular Agents - economics
Cardiovascular Diseases - drug therapy - economics
Drug Costs
Drug Prescriptions - economics
Humans
Prescription Fees - standards
Quality of Health Care
Rate Setting and Review
Societies, Medical
PubMed ID
9627521 View in PubMed
Less detail
Source
Pharos Alpha Omega Alpha Honor Med Soc. 2002;65(4):58-9
Publication Type
Article
Date
2002

Clopidogrel: a pharmacoeconomic review of its use in patients with non-ST elevation acute coronary syndromes.

https://arctichealth.org/en/permalink/ahliterature81701
Source
Pharmacoeconomics. 2006;24(7):709-26
Publication Type
Article
Date
2006
Author
Lyseng-Williamson Katherine A
Plosker Greg L
Author Affiliation
Adis International Limited, Mairangi Bay, Auckland, New Zealand. demail@adis.co.nz
Source
Pharmacoeconomics. 2006;24(7):709-26
Date
2006
Language
English
Publication Type
Article
Keywords
Anti-Inflammatory Agents, Non-Steroidal - adverse effects - economics - therapeutic use
Aspirin - adverse effects - economics - therapeutic use
Coronary Disease - drug therapy - epidemiology
Cost-Benefit Analysis
Economics, Pharmaceutical
Humans
Markov Chains
Platelet Aggregation Inhibitors - adverse effects - economics - therapeutic use
Prescription Fees - statistics & numerical data
Quality-Adjusted Life Years
Randomized Controlled Trials
Ticlopidine - adverse effects - analogs & derivatives - economics - therapeutic use
Abstract
Clopidogrel (Plavix) is a selective inhibitor of adenosine diphosphate-induced platelet aggregation. In patients with acute coronary syndromes (ACS) [unstable angina or non-ST-segment elevation myocardial infarction], clopidogrel plus aspirin (acetylsalicylic acid) for up to 1 year significantly reduced the risk of cardiovascular events relative to placebo plus aspirin in the well designed clinical trial CURE (Clopidogrel in Unstable angina to prevent Recurrent Events) and its substudy in patients undergoing percutaneous coronary intervention (PCI) [PCI-CURE]. In pharmacoeconomic evaluations based on data from these trials conducted in a number of countries that used a variety of models, methods and/or type of costs, clopidogrel plus aspirin was consistently predicted to be cost effective relative to aspirin alone in the management of patients with ACS, including those undergoing PCI. Clopidogrel plus aspirin in patients with ACS reduced the incremental cost per cardiovascular event prevented and/or life-year gained (LYG) relative to aspirin alone in analyses using within-trial data (including longer-term analyses incorporating life-expectancy estimates) from the CURE or PCI-CURE studies. In Markov models of cost effectiveness with a lifetime horizon from a healthcare payer perspective based on the CURE trial, relative to aspirin alone, clopidogrel plus aspirin for 1 year was predicted to have incremental costs per LYG of 8132Euro in Spain (2003 values) and 1365Euro in Sweden (2000 values). In similar Swedish analyses from a healthcare payer perspective, clopidogrel plus aspirin for 1 year was predicted to have incremental costs per LYG of 10,993Euro (2004 values) relative to aspirin alone based on data from the PCI-CURE substudy. Broadly similar results have also been reported in modelled analyses from other countries. Cost-utility analyses based on the CURE trial suggest that, relative to lifelong aspirin alone, clopidogrel plus aspirin for 1 year followed by aspirin alone is associated with incremental costs per QALY gained that are below the traditional threshold of cost utility in Spain, the UK and the US. In patients with ACS, including those undergoing PCI, the addition of clopidogrel to standard therapy with aspirin is clinically effective in preventing cardiovascular events. Available pharmacoeconomic data from several countries, despite some inherent limitations, support the use of clopidogrel plus aspirin for up to 1 year as a cost-effective treatment relative to aspirin alone in this patient population.
PubMed ID
16802846 View in PubMed
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Consumers devise drug cost-cutting measures: medical and legal issues to consider.

https://arctichealth.org/en/permalink/ahliterature183802
Source
Health Care Manag (Frederick). 2003 Jul-Sep;22(3):275-81
Publication Type
Article
Author
Gouranga Ganguli
Author Affiliation
Department of Accounting and Business Law, 1201 W. University Drive, University of Texas-Pan American, Edinburgh, TX 78539, USA.
Source
Health Care Manag (Frederick). 2003 Jul-Sep;22(3):275-81
Language
English
Publication Type
Article
Keywords
Aged
Canada
Consumer Participation - economics - legislation & jurisprudence
Cost Control - methods
Drug Costs - legislation & jurisprudence - statistics & numerical data
Drug Prescriptions - economics - statistics & numerical data
Drugs, Generic - economics
Financing, Personal - trends
Humans
Mexico
Middle Aged
Patient compliance
Prescription Fees - statistics & numerical data
Socioeconomic Factors
Travel
United States
Abstract
Health care costs in general, and prescription drug costs in particular, are rapidly rising. Between 1996 and 2007 the average annual per capita health care cost is projected to increase from dollar 3,781 to dollar 7,100. [AQ1] The single leading component of health care cost is the cost of prescription drugs (currently 10% of total health care spending, projected to become 18% in 2008). The average cost per drug increased 40% during the 1993-1998 period. Forty-one million Americans have no health insurance, and those who have, have inadequate prescription drug coverage. [AQ2] To cope with this situation, many consumers are trying to economize by doing without the prescriptions or the appropriate doses, buying generics or medicines from Canada or Mexico, or splitting pills of higher doses to take advantage of the pricing policy of drug manufacturers. Some of these approaches are medically and/or legally acceptable, while some are dubious. Most adversely affected are the seniors and poor; for certain groups of seniors prescription drugs account for 30% of their health care spending. The problem must receive prompt concerted attention from consumers, insurers, pharmaceutical companies, and lawmakers before it gets out of hand.
PubMed ID
12956230 View in PubMed
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54 records – page 1 of 6.