東華大學圖書館 |

語系: 繁體中文

說明(常見問題)

回圖書館首頁

手機版館藏查詢

登入

回首頁

切換: 標籤 | MARC模式 | ISBD

Impact of a change in prescription d...

Leung, Musetta Y.

FindBook

Google Book

Amazon

博客來

Impact of a change in prescription drug benefit on utilization and expenditures among patients receiving cardiovascular medications.

紀錄類型:	書目-電子資源 : Monograph/item
正題名/作者:	Impact of a change in prescription drug benefit on utilization and expenditures among patients receiving cardiovascular medications./
作者:	Leung, Musetta Y.
面頁冊數:	189 p.
附註:	Source: Dissertation Abstracts International, Volume: 67-06, Section: B, page: 3041.
Contained By:	Dissertation Abstracts International67-06B.
標題:	Health Sciences, Pharmacy. -
電子資源:	http://pqdd.sinica.edu.tw/twdaoapp/servlet/advanced?query=3222989
ISBN:	9780542734519

Impact of a change in prescription drug benefit on utilization and expenditures among patients receiving cardiovascular medications.
Leung, Musetta Y.

Impact of a change in prescription drug benefit on utilization and expenditures among patients receiving cardiovascular medications. - 189 p.

Source: Dissertation Abstracts International, Volume: 67-06, Section: B, page: 3041.

Thesis (Ph.D.)--Brandeis University, The Heller School for Social Policy and Management, 2006.

The rapid growth of pharmaceutical expenditure has prompted payers to adopt various cost-containment mechanisms, including incentive-based formularies. Beginning in January 2000, Tufts Health Plan implemented a change in outpatient prescription drug benefit change from a 2-tier (generic/brand) to a 3-tier (generic/preferred brand/non-preferred brand) formulary structure with increases in copayments. This quasi-experimental research used a pre-post control design to study the utilization patterns of prescription drugs and medical services among enrollees who were prescribed cardiovascular medications before and after the benefit change. Theoretical frameworks included both economic theories of demand and the Andersen and Newman model of health services utilization. Data from 1999 to 2001 included enrollment data, provider information, drug, medical and inpatient claims. Time trend analysis and difference-indifference techniques were used to ascertain the impact of the 3-tier program. A total of 6,477 people were included in the analysis. Difference-in-difference analysis found that among patients with prescriptions for an ever non-preferred drug, there was a significant decrease in NP drug use, but an increase in generic use. Mail order use also increased in the intervention group. The 3-tier implementation led to higher patient out-of-pocket (OOP) spending but reduced health plan spending by 17% for cardiovascular drugs. Both the control and intervention cohorts had more drug switching and discontinuation in the post-period, but this phenomenon was not attributable to the 3-tier implementation. In general, switchers and discontinuers were more likely to have physician visits for any reason, but hospitalizations were unaffected. Overall, there were increases in patient outof-pocket costs, but spending by the health plan did not increase or decrease significantly. In general, demand for cardiovascular drugs among this under 65 population was somewhat price-inelastic. This study gave evidence to how a plan could contain costs by shifting some of the burden onto the consumer, while not limiting access or adversely affecting patient outcomes.

ISBN: 9780542734519Subjects--Topical Terms:

1017737
Health Sciences, Pharmacy.

Impact of a change in prescription drug benefit on utilization and expenditures among patients receiving cardiovascular medications.
LDR:03189nmm 2200289 4500 001 1828356
005 20071112135325.5
008 130610s2006 eng d
020 $a 9780542734519
035 $a (UMI)AAI3222989
035 $a AAI3222989
040 $a UMI $c UMI
100 1 $a Leung, Musetta Y. $3 1917256
245 1 0 $a Impact of a change in prescription drug benefit on utilization and expenditures among patients receiving cardiovascular medications.
300 $a 189 p.
500 $a Source: Dissertation Abstracts International, Volume: 67-06, Section: B, page: 3041.
500 $a Adviser: Dominic Hodgkin.
502 $a Thesis (Ph.D.)--Brandeis University, The Heller School for Social Policy and Management, 2006.
520 $a The rapid growth of pharmaceutical expenditure has prompted payers to adopt various cost-containment mechanisms, including incentive-based formularies. Beginning in January 2000, Tufts Health Plan implemented a change in outpatient prescription drug benefit change from a 2-tier (generic/brand) to a 3-tier (generic/preferred brand/non-preferred brand) formulary structure with increases in copayments. This quasi-experimental research used a pre-post control design to study the utilization patterns of prescription drugs and medical services among enrollees who were prescribed cardiovascular medications before and after the benefit change. Theoretical frameworks included both economic theories of demand and the Andersen and Newman model of health services utilization. Data from 1999 to 2001 included enrollment data, provider information, drug, medical and inpatient claims. Time trend analysis and difference-indifference techniques were used to ascertain the impact of the 3-tier program. A total of 6,477 people were included in the analysis. Difference-in-difference analysis found that among patients with prescriptions for an ever non-preferred drug, there was a significant decrease in NP drug use, but an increase in generic use. Mail order use also increased in the intervention group. The 3-tier implementation led to higher patient out-of-pocket (OOP) spending but reduced health plan spending by 17% for cardiovascular drugs. Both the control and intervention cohorts had more drug switching and discontinuation in the post-period, but this phenomenon was not attributable to the 3-tier implementation. In general, switchers and discontinuers were more likely to have physician visits for any reason, but hospitalizations were unaffected. Overall, there were increases in patient outof-pocket costs, but spending by the health plan did not increase or decrease significantly. In general, demand for cardiovascular drugs among this under 65 population was somewhat price-inelastic. This study gave evidence to how a plan could contain costs by shifting some of the burden onto the consumer, while not limiting access or adversely affecting patient outcomes.
590 $a School code: 0541.
650 4 $a Health Sciences, Pharmacy. $3 1017737
650 4 $a Sociology, Public and Social Welfare. $3 1017909
650 4 $a Health Sciences, Health Care Management. $3 1017922
690 $a 0572
690 $a 0630
690 $a 0769
710 2 0 $a Brandeis University, The Heller School for Social Policy and Management. $3 1024624
773 0 $t Dissertation Abstracts International $g 67-06B.
790 1 0 $a Hodgkin, Dominic, $e advisor
790 $a 0541
791 $a Ph.D.
792 $a 2006
856 4 0 $u http://pqdd.sinica.edu.tw/twdaoapp/servlet/advanced?query=3222989