Benefit plan design and prescription drug utilization among asthmatics: do patient copayments matter?
Objective: The ratio of controller to reliever medication use has been proposed as a measure of treatment quality for asthma patients. In this study we examine the effects of plan level mean out-of-pocket asthma medication patient copayments and other features of benefit plan design on the use of co...
Gespeichert in:
| Format: | Buch |
|---|---|
| Sprache: | English |
| Veröffentlicht: |
Cambridge, Mass.
National Bureau of Economic Research
2003
|
| Schriftenreihe: | National Bureau of Economic Research <Cambridge, Mass.>: NBER working paper series
10062 |
| Schlagworte: | |
| Online-Zugang: | Volltext |
| Zusammenfassung: | Objective: The ratio of controller to reliever medication use has been proposed as a measure of treatment quality for asthma patients. In this study we examine the effects of plan level mean out-of-pocket asthma medication patient copayments and other features of benefit plan design on the use of controller medications alone, controller and reliever medications (combination therapy), and reliever medications alone. Methods: 1995-2000 MarketScan claims data were used to construct plan-level out-of-pocket copayment and physician/practice prescriber preference variables for asthma medications. Separate multinomial logit models were estimated for patients in fee-for-service (FFS) and non-FFS plans relating benefit plan design features, physician/practice prescribing preferences, patient demographics, patient comorbidities and county-level income variables to patient-level asthma treatment patterns. Results: We find that the controller reliever ratio rose steadily over 1995-2000, along with out-of-pocket payments for asthma medications, which rose more for controllers than for relievers. However, after controlling for other variables, plan level mean out-of-pocket copayments were not found to have a statistically significant influence upon patient-level asthma treatment patterns. On the other hand, physician practice prescribing patterns strongly influenced patient level treatment patterns. Conclusions: There is no strong statistical evidence that higher levels of out-of-pocket copayments for prescription drugs influence asthma treatment patterns. However, physician/practice prescribing preferences influence patient treatment. |
| Beschreibung: | 26, [3] S. graph. Darst. |
Internformat
MARC
| LEADER | 00000nam a2200000zcb4500 | ||
|---|---|---|---|
| 001 | BV023590544 | ||
| 003 | DE-604 | ||
| 005 | 20091116 | ||
| 007 | t| | ||
| 008 | 021128s2003 xxud||| |||| 00||| eng d | ||
| 035 | |a (OCoLC)249358715 | ||
| 035 | |a (DE-599)BVBBV023590544 | ||
| 040 | |a DE-604 |b ger | ||
| 041 | 0 | |a eng | |
| 044 | |a xxu |c XD-US | ||
| 049 | |a DE-521 | ||
| 245 | 1 | 0 | |a Benefit plan design and prescription drug utilization among asthmatics |b do patient copayments matter? |c William H. Crown ... |
| 264 | 1 | |a Cambridge, Mass. |b National Bureau of Economic Research |c 2003 | |
| 300 | |a 26, [3] S. |b graph. Darst. | ||
| 336 | |b txt |2 rdacontent | ||
| 337 | |b n |2 rdamedia | ||
| 338 | |b nc |2 rdacarrier | ||
| 490 | 1 | |a National Bureau of Economic Research <Cambridge, Mass.>: NBER working paper series |v 10062 | |
| 520 | 3 | |a Objective: The ratio of controller to reliever medication use has been proposed as a measure of treatment quality for asthma patients. In this study we examine the effects of plan level mean out-of-pocket asthma medication patient copayments and other features of benefit plan design on the use of controller medications alone, controller and reliever medications (combination therapy), and reliever medications alone. Methods: 1995-2000 MarketScan claims data were used to construct plan-level out-of-pocket copayment and physician/practice prescriber preference variables for asthma medications. Separate multinomial logit models were estimated for patients in fee-for-service (FFS) and non-FFS plans relating benefit plan design features, physician/practice prescribing preferences, patient demographics, patient comorbidities and county-level income variables to patient-level asthma treatment patterns. Results: We find that the controller reliever ratio rose steadily over 1995-2000, along with out-of-pocket payments for asthma medications, which rose more for controllers than for relievers. However, after controlling for other variables, plan level mean out-of-pocket copayments were not found to have a statistically significant influence upon patient-level asthma treatment patterns. On the other hand, physician practice prescribing patterns strongly influenced patient level treatment patterns. Conclusions: There is no strong statistical evidence that higher levels of out-of-pocket copayments for prescription drugs influence asthma treatment patterns. However, physician/practice prescribing preferences influence patient treatment. | |
| 650 | 4 | |a Krankenversicherung / Pharmazeutisches Produkt / Krankheit / USA | |
| 700 | 1 | |a Crown, William H. |d 1954- |e Sonstige |0 (DE-588)170422941 |4 oth | |
| 700 | 1 | |a Berndt, Ernst R. |e Sonstige |0 (DE-588)128550783 |4 oth | |
| 700 | 1 | |a Haver, Kenan E. |e Sonstige |4 oth | |
| 776 | 0 | 8 | |i Erscheint auch als |n Online-Ausgabe |
| 830 | 0 | |a National Bureau of Economic Research <Cambridge, Mass.>: NBER working paper series |v 10062 |w (DE-604)BV002801238 |9 10062 | |
| 856 | 4 | 1 | |u http://papers.nber.org/papers/w10062.pdf |z kostenfrei |3 Volltext |
| 943 | 1 | |a oai:aleph.bib-bvb.de:BVB01-016905874 | |
Datensatz im Suchindex
| _version_ | 1826582113527267330 |
|---|---|
| adam_text | |
| adam_txt | |
| any_adam_object | |
| any_adam_object_boolean | |
| author_GND | (DE-588)170422941 (DE-588)128550783 |
| building | Verbundindex |
| bvnumber | BV023590544 |
| ctrlnum | (OCoLC)249358715 (DE-599)BVBBV023590544 |
| format | Book |
| fullrecord | <?xml version="1.0" encoding="UTF-8"?><collection xmlns="http://www.loc.gov/MARC21/slim"><record><leader>00000nam a2200000zcb4500</leader><controlfield tag="001">BV023590544</controlfield><controlfield tag="003">DE-604</controlfield><controlfield tag="005">20091116</controlfield><controlfield tag="007">t|</controlfield><controlfield tag="008">021128s2003 xxud||| |||| 00||| eng d</controlfield><datafield tag="035" ind1=" " ind2=" "><subfield code="a">(OCoLC)249358715</subfield></datafield><datafield tag="035" ind1=" " ind2=" "><subfield code="a">(DE-599)BVBBV023590544</subfield></datafield><datafield tag="040" ind1=" " ind2=" "><subfield code="a">DE-604</subfield><subfield code="b">ger</subfield></datafield><datafield tag="041" ind1="0" ind2=" "><subfield code="a">eng</subfield></datafield><datafield tag="044" ind1=" " ind2=" "><subfield code="a">xxu</subfield><subfield code="c">XD-US</subfield></datafield><datafield tag="049" ind1=" " ind2=" "><subfield code="a">DE-521</subfield></datafield><datafield tag="245" ind1="1" ind2="0"><subfield code="a">Benefit plan design and prescription drug utilization among asthmatics</subfield><subfield code="b">do patient copayments matter?</subfield><subfield code="c">William H. Crown ...</subfield></datafield><datafield tag="264" ind1=" " ind2="1"><subfield code="a">Cambridge, Mass.</subfield><subfield code="b">National Bureau of Economic Research</subfield><subfield code="c">2003</subfield></datafield><datafield tag="300" ind1=" " ind2=" "><subfield code="a">26, [3] S.</subfield><subfield code="b">graph. Darst.</subfield></datafield><datafield tag="336" ind1=" " ind2=" "><subfield code="b">txt</subfield><subfield code="2">rdacontent</subfield></datafield><datafield tag="337" ind1=" " ind2=" "><subfield code="b">n</subfield><subfield code="2">rdamedia</subfield></datafield><datafield tag="338" ind1=" " ind2=" "><subfield code="b">nc</subfield><subfield code="2">rdacarrier</subfield></datafield><datafield tag="490" ind1="1" ind2=" "><subfield code="a">National Bureau of Economic Research <Cambridge, Mass.>: NBER working paper series</subfield><subfield code="v">10062</subfield></datafield><datafield tag="520" ind1="3" ind2=" "><subfield code="a">Objective: The ratio of controller to reliever medication use has been proposed as a measure of treatment quality for asthma patients. In this study we examine the effects of plan level mean out-of-pocket asthma medication patient copayments and other features of benefit plan design on the use of controller medications alone, controller and reliever medications (combination therapy), and reliever medications alone. Methods: 1995-2000 MarketScan claims data were used to construct plan-level out-of-pocket copayment and physician/practice prescriber preference variables for asthma medications. Separate multinomial logit models were estimated for patients in fee-for-service (FFS) and non-FFS plans relating benefit plan design features, physician/practice prescribing preferences, patient demographics, patient comorbidities and county-level income variables to patient-level asthma treatment patterns. Results: We find that the controller reliever ratio rose steadily over 1995-2000, along with out-of-pocket payments for asthma medications, which rose more for controllers than for relievers. However, after controlling for other variables, plan level mean out-of-pocket copayments were not found to have a statistically significant influence upon patient-level asthma treatment patterns. On the other hand, physician practice prescribing patterns strongly influenced patient level treatment patterns. Conclusions: There is no strong statistical evidence that higher levels of out-of-pocket copayments for prescription drugs influence asthma treatment patterns. However, physician/practice prescribing preferences influence patient treatment.</subfield></datafield><datafield tag="650" ind1=" " ind2="4"><subfield code="a">Krankenversicherung / Pharmazeutisches Produkt / Krankheit / USA</subfield></datafield><datafield tag="700" ind1="1" ind2=" "><subfield code="a">Crown, William H.</subfield><subfield code="d">1954-</subfield><subfield code="e">Sonstige</subfield><subfield code="0">(DE-588)170422941</subfield><subfield code="4">oth</subfield></datafield><datafield tag="700" ind1="1" ind2=" "><subfield code="a">Berndt, Ernst R.</subfield><subfield code="e">Sonstige</subfield><subfield code="0">(DE-588)128550783</subfield><subfield code="4">oth</subfield></datafield><datafield tag="700" ind1="1" ind2=" "><subfield code="a">Haver, Kenan E.</subfield><subfield code="e">Sonstige</subfield><subfield code="4">oth</subfield></datafield><datafield tag="776" ind1="0" ind2="8"><subfield code="i">Erscheint auch als</subfield><subfield code="n">Online-Ausgabe</subfield></datafield><datafield tag="830" ind1=" " ind2="0"><subfield code="a">National Bureau of Economic Research <Cambridge, Mass.>: NBER working paper series</subfield><subfield code="v">10062</subfield><subfield code="w">(DE-604)BV002801238</subfield><subfield code="9">10062</subfield></datafield><datafield tag="856" ind1="4" ind2="1"><subfield code="u">http://papers.nber.org/papers/w10062.pdf</subfield><subfield code="z">kostenfrei</subfield><subfield code="3">Volltext</subfield></datafield><datafield tag="943" ind1="1" ind2=" "><subfield code="a">oai:aleph.bib-bvb.de:BVB01-016905874</subfield></datafield></record></collection> |
| id | DE-604.BV023590544 |
| illustrated | Illustrated |
| index_date | 2024-07-02T22:41:26Z |
| indexdate | 2025-03-14T15:00:48Z |
| institution | BVB |
| language | English |
| oai_aleph_id | oai:aleph.bib-bvb.de:BVB01-016905874 |
| oclc_num | 249358715 |
| open_access_boolean | 1 |
| owner | DE-521 |
| owner_facet | DE-521 |
| physical | 26, [3] S. graph. Darst. |
| publishDate | 2003 |
| publishDateSearch | 2003 |
| publishDateSort | 2003 |
| publisher | National Bureau of Economic Research |
| record_format | marc |
| series | National Bureau of Economic Research <Cambridge, Mass.>: NBER working paper series |
| series2 | National Bureau of Economic Research <Cambridge, Mass.>: NBER working paper series |
| spelling | Benefit plan design and prescription drug utilization among asthmatics do patient copayments matter? William H. Crown ... Cambridge, Mass. National Bureau of Economic Research 2003 26, [3] S. graph. Darst. txt rdacontent n rdamedia nc rdacarrier National Bureau of Economic Research <Cambridge, Mass.>: NBER working paper series 10062 Objective: The ratio of controller to reliever medication use has been proposed as a measure of treatment quality for asthma patients. In this study we examine the effects of plan level mean out-of-pocket asthma medication patient copayments and other features of benefit plan design on the use of controller medications alone, controller and reliever medications (combination therapy), and reliever medications alone. Methods: 1995-2000 MarketScan claims data were used to construct plan-level out-of-pocket copayment and physician/practice prescriber preference variables for asthma medications. Separate multinomial logit models were estimated for patients in fee-for-service (FFS) and non-FFS plans relating benefit plan design features, physician/practice prescribing preferences, patient demographics, patient comorbidities and county-level income variables to patient-level asthma treatment patterns. Results: We find that the controller reliever ratio rose steadily over 1995-2000, along with out-of-pocket payments for asthma medications, which rose more for controllers than for relievers. However, after controlling for other variables, plan level mean out-of-pocket copayments were not found to have a statistically significant influence upon patient-level asthma treatment patterns. On the other hand, physician practice prescribing patterns strongly influenced patient level treatment patterns. Conclusions: There is no strong statistical evidence that higher levels of out-of-pocket copayments for prescription drugs influence asthma treatment patterns. However, physician/practice prescribing preferences influence patient treatment. Krankenversicherung / Pharmazeutisches Produkt / Krankheit / USA Crown, William H. 1954- Sonstige (DE-588)170422941 oth Berndt, Ernst R. Sonstige (DE-588)128550783 oth Haver, Kenan E. Sonstige oth Erscheint auch als Online-Ausgabe National Bureau of Economic Research <Cambridge, Mass.>: NBER working paper series 10062 (DE-604)BV002801238 10062 http://papers.nber.org/papers/w10062.pdf kostenfrei Volltext |
| spellingShingle | Benefit plan design and prescription drug utilization among asthmatics do patient copayments matter? National Bureau of Economic Research <Cambridge, Mass.>: NBER working paper series Krankenversicherung / Pharmazeutisches Produkt / Krankheit / USA |
| title | Benefit plan design and prescription drug utilization among asthmatics do patient copayments matter? |
| title_auth | Benefit plan design and prescription drug utilization among asthmatics do patient copayments matter? |
| title_exact_search | Benefit plan design and prescription drug utilization among asthmatics do patient copayments matter? |
| title_exact_search_txtP | Benefit plan design and prescription drug utilization among asthmatics do patient copayments matter? |
| title_full | Benefit plan design and prescription drug utilization among asthmatics do patient copayments matter? William H. Crown ... |
| title_fullStr | Benefit plan design and prescription drug utilization among asthmatics do patient copayments matter? William H. Crown ... |
| title_full_unstemmed | Benefit plan design and prescription drug utilization among asthmatics do patient copayments matter? William H. Crown ... |
| title_short | Benefit plan design and prescription drug utilization among asthmatics |
| title_sort | benefit plan design and prescription drug utilization among asthmatics do patient copayments matter |
| title_sub | do patient copayments matter? |
| topic | Krankenversicherung / Pharmazeutisches Produkt / Krankheit / USA |
| topic_facet | Krankenversicherung / Pharmazeutisches Produkt / Krankheit / USA |
| url | http://papers.nber.org/papers/w10062.pdf |
| volume_link | (DE-604)BV002801238 |
| work_keys_str_mv | AT crownwilliamh benefitplandesignandprescriptiondrugutilizationamongasthmaticsdopatientcopaymentsmatter AT berndternstr benefitplandesignandprescriptiondrugutilizationamongasthmaticsdopatientcopaymentsmatter AT haverkenane benefitplandesignandprescriptiondrugutilizationamongasthmaticsdopatientcopaymentsmatter |