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Effect of switching to a high-deductible health plan on use of chronic medications.

Publication ,  Journal Article
Reiss, SK; Ross-Degnan, D; Zhang, F; Soumerai, SB; Zaslavsky, AM; Wharam, JF
Published in: Health Serv Res
October 2011

OBJECTIVE: To examine whether high-deductible health plans (HDHPs) that exempt prescription drugs from full cost sharing preserve medication use for major chronic illness, compared with traditional HMOs with similar drug cost sharing. DATA SOURCES/STUDY SETTING: We examined 2001-2008 pharmacy claims data of 3,348 continuously enrolled adults in a Massachusetts health plan for 9 months before and 24 months after an employer-mandated switch from a traditional HMO plan to a HDHP, compared with 20,534 contemporaneous matched HMO members. Both study groups faced similar three-tiered drug copayments. We calculated daily medication availability for all prescription drugs and four chronic medication classes: hypoglycemics, lipid-lowering agents, antihypertensives, and chronic obstructive pulmonary disease (COPD)/asthma controllers. STUDY DESIGN: Interrupted time-series with comparison group study design examining monthly level and trend changes in prescription drug utilization. PRINCIPAL FINDINGS: The HDHP and control groups had comparable changes in the level and trend of all drugs after the index date; we detected similar patterns in the use of lipid-lowering agents, antihypertensives, and COPD/asthma controllers. Some evidence suggested a small relative decline in hypoglycemic use among diabetic patients in HDHPs. CONCLUSIONS: Switching to an HDHP that included modest drug copayments did not change medication availability or reduce use of essential medications for three common chronic illnesses.

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Published In

Health Serv Res

DOI

EISSN

1475-6773

Publication Date

October 2011

Volume

46

Issue

5

Start / End Page

1382 / 1401

Location

United States

Related Subject Headings

  • Pulmonary Disease, Chronic Obstructive
  • Middle Aged
  • Massachusetts
  • Male
  • Insurance, Pharmaceutical Services
  • Insurance Claim Review
  • Hypertension
  • Hyperlipidemias
  • Humans
  • Health Services Research
 

Citation

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Reiss, S. K., Ross-Degnan, D., Zhang, F., Soumerai, S. B., Zaslavsky, A. M., & Wharam, J. F. (2011). Effect of switching to a high-deductible health plan on use of chronic medications. Health Serv Res, 46(5), 1382–1401. https://doi.org/10.1111/j.1475-6773.2011.01252.x
Reiss, Sheila K., Dennis Ross-Degnan, Fang Zhang, Stephen B. Soumerai, Alan M. Zaslavsky, and J Frank Wharam. “Effect of switching to a high-deductible health plan on use of chronic medications.Health Serv Res 46, no. 5 (October 2011): 1382–1401. https://doi.org/10.1111/j.1475-6773.2011.01252.x.
Reiss SK, Ross-Degnan D, Zhang F, Soumerai SB, Zaslavsky AM, Wharam JF. Effect of switching to a high-deductible health plan on use of chronic medications. Health Serv Res. 2011 Oct;46(5):1382–401.
Reiss, Sheila K., et al. “Effect of switching to a high-deductible health plan on use of chronic medications.Health Serv Res, vol. 46, no. 5, Oct. 2011, pp. 1382–401. Pubmed, doi:10.1111/j.1475-6773.2011.01252.x.
Reiss SK, Ross-Degnan D, Zhang F, Soumerai SB, Zaslavsky AM, Wharam JF. Effect of switching to a high-deductible health plan on use of chronic medications. Health Serv Res. 2011 Oct;46(5):1382–1401.
Journal cover image

Published In

Health Serv Res

DOI

EISSN

1475-6773

Publication Date

October 2011

Volume

46

Issue

5

Start / End Page

1382 / 1401

Location

United States

Related Subject Headings

  • Pulmonary Disease, Chronic Obstructive
  • Middle Aged
  • Massachusetts
  • Male
  • Insurance, Pharmaceutical Services
  • Insurance Claim Review
  • Hypertension
  • Hyperlipidemias
  • Humans
  • Health Services Research