Consumer response to dual incentives under multitiered prescription drug formularies

American Journal of Managed Care

Volumn 13, Issue 6 II, 2007, Pages 353-359

  Gilman, Boyd H ^a   Kautter, John ^b  

^a MATHEMATICA POLICY RESEARCH   (United States)

^b RTI INTERNATIONAL   (United States)

Author keywords

[No Author keywords available]

Indexed keywords

GENERIC DRUG;

ARTICLE; COST CONTROL; DRUG COST; DRUG FORMULARY; HEALTH CARE ACCESS; HEALTH CARE FINANCING; HEALTH INSURANCE; MOTIVATION; MULTIVARIATE ANALYSIS; PRESCRIPTION; PRIORITY JOURNAL;

AGE DISTRIBUTION; AGED; AGED, 80 AND OVER; CONSUMER SATISFACTION; DEDUCTIBLES AND COINSURANCE; DRUG UTILIZATION REVIEW; FEMALE; FORMULARIES; HEALTH CARE SURVEYS; HEALTH STATUS; HUMANS; INSURANCE, PHARMACEUTICAL SERVICES; MALE; MEDICARE; MULTIVARIATE ANALYSIS; PRESCRIPTION FEES; REGRESSION ANALYSIS; SEX DISTRIBUTION; UNITED STATES;

EID: 34250903632     PISSN: 10880224     EISSN: None     Source Type: Journal    
DOI: None     Document Type: Article

References (25)

1. Kaiser Family Foundation and Health Research and Educational Trust. Employer Health Benefits 2005 Employer Survey. September 2005. Available at: http://www.kff.org/insurance/7315/exhibits/index. cfm. Accessed April 4, 2007.
2. Hoadley J. The Effect of Formularies and Other Cost Management Tools on Access to Medications: An Analysis of the MMA and the Final Rule. Menlo Park, Calif: Kaiser Family Foundation; March 2005.
3. Thomas CP. Incentive-based formularies. N Engl J Med. 2003;349: 2186-2188.
4. Hoadley J. Cost Containment Strategies for Prescription Drugs: Assessing the Evidence in the Literature. Menlo Park, Calif: Kaiser Family Foundation; March 2005.
5. Joyce GF, Escarce JJ, Solomon MD, Goldman DP. Employer drug benefit plans and spending on prescription drugs. JAMA. 2002;288: 1733-1739.
6. Motheral B, Fairman KA. Effect of a three-tiered prescription copay on pharmaceutical and other medical utilization. Med Care. 2001;39: 1293-1304.
7. Fairman KA, Motheral BR, Henderson RR. Retrospective, long-term follow-up study of the effect of a three-tier prescription drug copayment system on pharmaceutical and other medical utilization and costs. Clin Ther. 2003;25:3147-3161.
8. Huskamp HA, Deverka PA, Epstein AM, et al. Impact of 3-tiered formularies on drug treatment of attention-deficit/hyperactivity disorder in children. Arch Gen Psychiatry. 2005;62:435-441.
9. Huskamp HA, Deverka PA, Epstein AM, et al. The effect of incentive-based formularies on prescription drug utilization and spending. N Engl J Med. 2003;349:2224-2232.
10. Gibson TB, Ozminkowski RJ, Goetzel RZ. The effects of prescription drug cost sharing: a review of the evidence. Am J Manag Care. 2005;11: 730-740.
11. Goldman DP, Joyce GF, Escarce JJ, et al. Pharmacy benefits and the use of drugs by the chronically ill. JAMA. 2004;291:2344-2350.
12. Briesacher B, Kamal-Bahl S, Hochberg M, Orwig D, Kahler KH. Three-tiered-copayment drug coverage and use of nonsteroidal antiinflammatory drugs. Arch Intern Med. 2004;164:1679-1684.
13. Landsman PB, Yu W, Liu X, Teutsch SM, Berger ML. Impact of 3-tiered pharmacy benefit design and increased consumer cost sharing on drug utilization. Am J Manag Care. 2005;11:621-628.
14. Gleason PP, Gunderson BW, Gericke KR. Are incentive-based formularies inversely associated with drug utilization in managed care? Ann Pharmacother. 2005;39:339-345.
15. Nair KV, Wolfe P, Zaluck RJ, et al. Effects of a 3-tiered pharmacy benefit design on the prescription purchasing behavior of individuals with chronic disease. J Manag Care Pharm. 2003;9:123-133.
16. Shrank WH, Fox SA, Kirk A, et al. The effect of pharmacy benefit design on patient-physician communication about costs. J Gen Intern Med. 2006;21:334-339.
17. Zhan C, Sangl J, Bierman AS, et al. Potentially inappropriate medication use in the community-dwelling elderly. JAMA. 2001;286: 2823-2829.
18. Contoyannis P, Hurley J, Grootendorst P, Jeon SH, Tamblyn R. Estimating the price elasticity of expenditure for prescription drugs in the presence of non-linear price schedules: an illustration from Quebec, Canada. Health Econ. 2005;14:909-923.
19. Gilman BH, Kautter J. Impact of multi-tiered copayments on the use and cost of prescription drugs among Medicare beneficiaries. Health Serv Res. In press.
20. Pope GC, Kautter J, Ellis RR et al. Risk adjustment of Medicare capitation payments using the CMS-HCC model. Health Care Financ Rev. 2004;25:119-141.
21. Thomas CP, Wallack SS, Lee S, Ritter GA. Impact of health plan design and management on retirees' prescription drug use and spending, 2001. Health Aff (Millwood). 2002;suppl Web exclusives:W408-W419.
22. Shrank WH, Hoang T, Ettner SL, et al. The implications of choice: prescribing generic or preferred pharmaceuticals improves medication adherence for chronic conditions. Arch Intern Med. 2006;166: 332-337.
23. Neumann PJ. Evidence-based and value-based formulary guidelines. Health Aff (Millwood). 2004;23:124-134.
24. Neumann PJ, Lin PJ, Greenberg D, et al. Do drug formulary policies reflect evidence of value? Am J Manag Care. 2006;12:30-36.
25. Fendrick AM, Chernew ME. Value-based insurance design: aligning incentives to bridge the divide between quality improvement and cost containment. Am J Manag Care. 2006;12:SP5-SP10.