Simulated value-based insurance design applied to statin use by Medicare beneficiaries with diabetes.

Value in Health : the Journal of the International Society for Pharmacoeconomics and Outcomes Research
Amy DavidoffJ Samantha Shoemaker

Abstract

To examine cost responsiveness and total costs associated with a simulated "value-based" insurance design for statin therapy in a Medicare population with diabetes. Four-year panels were constructed from the 1997-2005 Medicare Current Beneficiary Survey selected by self-report or claims-based diagnoses of diabetes in year 1 and use of statins in year 2 (N = 899). We computed the number of 30-day statin prescription fills, out-of-pocket and third-party drug costs, and Medicare Part A and Part B spending. Multivariate ordinary least squares regression models predicted statin fills as a function of out-of-pocket costs, and a generalized linear model with log link predicted Medicare spending as a function of number of fills, controlling for baseline characteristics. Estimated coefficients were used to simulate changes in fills associated with co-payment caps from $25 to $1 and to compute changes in third-party payments and Medicare cost offsets associated with incremental fills. Analyses were stratified by patient cardiovascular event risk. A simulated out-of-pocket price of $25 [$1] increased plan drug spending by $340 [$794] and generated Medicare Part A/B savings of $262 [$531]; savings for high-risk patients were $558 [$1193], ...Continue Reading

References

Dec 9, 1998·Health Economics·A Giuffrida, H Gravelle
Jan 7, 2000·American Journal of Medical Quality : the Official Journal of the American College of Medical Quality·P L HebertA M McBean
Apr 16, 2003·Journal of the American Geriatrics Society·Arlene F BrownUNKNOWN California Healthcare Foundation/American Geriatrics Society Panel on Improving Care for Elders with Diabetes
Dec 6, 2003·The New England Journal of Medicine·Haiden A HuskampRichard G Frank
May 20, 2004·JAMA : the Journal of the American Medical Association·Dana P GoldmanSteven M Teutsch
Jun 17, 2004·Circulation·Jean Davignon
Dec 24, 2004·Diabetes Care·Todd P GilmerLeif I Solberg
May 24, 2005·Medical Care·Michael C SokolRobert S Epstein
Jul 5, 2007·JAMA : the Journal of the American Medical Association·Dana P GoldmanYuhui Zheng
Dec 7, 2007·The Diabetes Educator·Peggy Soule Odegard, Kam Capoccia
Jan 24, 2008·Circulation·Ralph B D'AgostinoWilliam B Kannel
Apr 30, 2008·Journal of General Internal Medicine·Michael ChernewA Mark Fendrick
Apr 9, 2009·Implementation Science : IS·Alicen SpauldingAllison B Rosen
Nov 13, 2009·Diabetes Care·Yehuda KamariDror Harats
Nov 27, 2009·Diabetes Care·Elbert S HuangJames C Capretta
Jan 29, 2010·Diabetes Care·UNKNOWN American Diabetes Association
Jun 22, 2010·Value in Health : the Journal of the International Society for Pharmacoeconomics and Outcomes Research·Feng ZengMichael B Nichol
Nov 3, 2010·Health Affairs·Niteesh K ChoudhryWilliam H Shrank
Nov 3, 2010·Health Affairs·Matthew L MaciejewskiDaryl Wansink
Nov 3, 2010·Health Affairs·A Mark FendrickMichael E Chernew
Mar 19, 2011·Health Services Research·Bruce StuartJennifer Lloyd

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Citations

Aug 31, 2013·Diabetes Therapy : Research, Treatment and Education of Diabetes and Related Disorders·Luis-Emilio García-PérezDomingo Orozco-Beltrán
Jun 22, 2014·American Journal of Preventive Medicine·Nora B HenriksonDavid C Grossman
Nov 22, 2013·The Annals of Pharmacotherapy·Rashid KazerooniJonathan H Watanabe

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