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The effects of payments for pharmaceuticals: a systematic literature review

Published online by Cambridge University Press:  27 March 2017

Katarzyna Kolasa  and
Marta Kowalczyk
Katarzyna Kolasa*
Affiliation:
Health Economics, Uniwersytet Mikolaja Kopernika Collegium Medicum, Bydgoszcz, Poland
Marta Kowalczyk
Affiliation:
Pharmacoeconomics Department, Medical University of Warsaw, Poland
*
*Correspondence to: Katarzyna Kolasa, Health Economics, Uniwersytet Mikolaja Kopernika Collegium Medicum, Bydgoszcz 85-094, Poland. Email: kkolasa@wum.edu.pl
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Abstract

The existence of different forms of out-of-pocket payments (OOPs) for pharmaceuticals across the globe provokes the question whether they can achieve more negative or positive consequences. A systematic literature review was conducted to assess the association between drug cost sharing and health care services utilization, health care costs as well as health outcomes. Studies published in The Cochrane Library, PubMed, Embase were searched with such keywords as: drug, pharmaceutical, cost sharing, out of pocket, co-payments paired with the following: impact, health outcomes, health care costs and utilization. The final review included 18 articles. A total of 11 publications reported the association between drug cost sharing and health care utilization patterns, of which nine found a statistically significant direct relationship. In all 10 publications concerned the association between drug copayments and health care costs. Majority were limited to the impact on the drug budget. Seven studies looked into the link between drug cost sharing and health outcomes, of which five reported statistically significant inverse relationship. There is some evidence for the association between drug copayments, health outcomes and health care services consumption. The optimal system of OOPs’ payments for pharmaceuticals needs to prevent drugs’ overconsumption and mitigate the risks of excessive cost sharing’s burden.

Type
Articles
Information
Health Economics, Policy and Law , Volume 14 , Issue 3 , July 2019 , pp. 337 - 354
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Copyright
© Cambridge University Press 2017 

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References

Atella, V., Peracchi, F., Depalo, D. and Rossetti, C. (2006), ‘Drug compliance, co-payment and health outcomes: evidence from a panel of Italian patients’, Health Economics, 15(9): 875–892.Google Scholar
Baker, D. W., Sudano, J. J., Albert, J. M., Borawski, E. A. and Dor, A. (2001), ‘Lack of health insurance and decline in overall health in late middle age’, The New England Journal of Medicine, 345: 1106–1112.Google Scholar
Campbell, J. D., Allen-Ramey, F., Sajjan, S. G., Maiese, E. M. and Sullivan, S. D. (2011), ‘Increasing pharmaceutical copayments: impact on asthma medication utilization and outcomes’, The American Journal of Managed Care, 17(10): 703–710.Google Scholar
Chernew, M. E., Juster, I. A., Shah, M., Wegh, A., Rosenberg, S., Rosen, A. B., Sokol, M. C., Yu-Isenberg, K. and Fendrick, A. M. (2010), ‘Evidence that value-based insurance can be effective’, Health Affairs (Millwood), 29(3): 530–536.Google Scholar
Choudhry, N. K., Patrick, A. R., Antman, E. M., Avorn, J. and Shrank, W. H. (2008), ‘Cost-effectiveness of providing full drug coverage to increase medication adherence in post-myocardial infarction Medicare beneficiaries’, Circulation, 117(10): 1261–1268.Google Scholar
Choudhry, N. K., Fischer, M. A., Avorn, J., Schneeweiss, S., Solomon, D. H., Berman, C., Jan, S., Liu, J., Lii, J., Brookhart, M. A., Mahoney, J. J. and Shrank, W. H. (2010), ‘At Pitney Bowes, value-based insurance design cut copayments and increased drug adherence’, Health Affairs (Millwood), 29(11): 1995–2001.Google Scholar
Choudhry, N. K., Avorn, J., Glynn, R. J., Antman, E. M., Schneeweiss, S., Toscano, M., Reisman, L., Fernandes, J., Spettell, C., Lee, J. L., Levin, R., Brennan, T. and Shrank, W. H. (2011), ‘Full coverage for preventive medications after myocardial infarction’, The New England Journal of Medicine, 365(22): 2088–2097.Google Scholar
Choudhry, N. K., Fischer, M. A., Avorn, J. L., Lee, J. L., Schneeweiss, S., Solomon, D. H., Berman, C., Jan, S., Lii, J., Mahoney, J. J. and Shrank, W. H. (2012), ‘The impact of reducing cardiovascular medication copayments on health spending and resource utilization’, Journal of the American College of Cardiology, 60(18): 1817–1824.Google Scholar
Cole, J. A., Norman, H., Weatherby, L. B. and Walker, A. M. (2006), ‘Drug copayment and adherence in chronic heart failure: effect on cost and outcomes’, Pharmacotherapy, 26(8): 1157–1164.Google Scholar
Einav, L., Finkelstein, A., Ryan, S., Schrimpf, P. and Cullen, M. R. (2013), ‘Selection on moral hazard in health insurance’, American Economic Review, 103(1): 178–219.Google Scholar
Engelhardt, G. and Gruber, J. (2011), ‘Medicare part D and the financial protection of the elderly’, American Economic Journal: Economic Policy, 3(4): 77–102.Google Scholar
Eurostat. European Commission (2009), http://ec.europa.eu/consumers/strategy/consumers_europe_edition2_en.pdf [20 February 2016].Google Scholar
Fera, T., Bluml, B. M. and Ellis, W. M. (2009), ‘Diabetes ten city challenge: final economic and clinical results’, Journal of the American Pharmacists Association, 49(3): 383–391.Google Scholar
Fowler, N. R., Chen, Y. F., Thurton, C. A., Men, A., Rodriguez, E. G. and Donohue, J. M. (2013), ‘The impact of medicare prescription drug coverage on the use of antidementia drugs’, BMC Geriatrics, 13: 37.Google Scholar
Gardner, M. J., Machin, D. and Campbell, M. J. (1986), ‘Use of check lists in assessing the statistical content of medical studies’, British Medical Journal (Clinical Research ed.), 292(6523): 810–812.Google Scholar
Gibson, T. B., Ozminkowski, R. J. and Goetzel, R. Z. (2005), ‘The effects of prescription drug cost sharing: a review of the evidence’, The American Journal of Managed Care, 11(11): 730–740.Google Scholar
Hagström, B., Mattsson, B., Rost, I. M. and Gunnarsson, R. K. (2004), ‘What happened to the prescriptions? A single, short, standardized telephone call may increase compliance’, Family Practice, 21: 46–50.Google Scholar
Heisler, M., Langa, K. M., Eby, E. L., Fendrick, A. M., Kabeto, M. U. and Piette, J. D. (2004), ‘The health effects of restricting prescription medication use because of cost’, Medical Care, 42(7): 626–634.Google Scholar
Kim, E., Gupta, S., Bolge, S., Chen, C. C., Whitehead, R. and Bates, J. A. (2010), ‘Adherence and outcomes associated with copayment burden in schizophrenia: across-sectional survey’, Journal of Medical Economics, 13(2): 185–192.Google Scholar
Kircher, S. M., Johansen, M. E., Nimeiri, H. S., Richardson, C. R. and Davis, M. M. (2014), ‘Impact of medicare part D on out-of-pocket drug costs and medical use for patients with cancer’, Cancer, 120(21): 3378–3384.Google Scholar
Kogut, S. J., Johnson, S., Higgins, T. and Quilliam, B. (2012), ‘Evaluation of a program to improve diabetes care through intensified care management activities and diabetes medication copayment reduction’, Journal of Managed Care Pharmacy, 18(4): 297–310.Google Scholar
Kulik, A., Desai, N. R., Shrank, W. H., Antman, E. M., Glynn, R. J., Levin, R., Reisman, L., Brennan, T. and Choudhry, N. K. (2013), ‘Full prescription coverage versus usual prescription coverage after coronary artery bypass graft surgery: analysis from the post-myocardial infarction free Rx event and economic evaluation (FREEE) randomized trial’, Circulation, 128(Supplement 1): S219–S225.Google Scholar
Landsman, P. B., Yu, W., Liu, X., Teutsch, S. M. and Berger, M. L. (2005), ‘Impact of 3-tier pharmacy benefit design and increased consumer cost sharing on drug utilization’, American Journal of Managed Care, 11: 621–628.Google Scholar
Lexchin, J. and Grootendorst, P. (2004), ‘Effects of prescription drug user fees on drug and health services use and on health status in vulnerable populations: a systematic review of the evidence’, International Journal of Health Services, 34: 101–122.Google Scholar
Li, X., Guh, D., Lacaille, D., Esdaile, J. and Anis, A. H. (2007), ‘The impact of cost sharing of prescription drug expenditures on health care utilization by the elderly: own- and cross-price elasticities’, Health Policy, 82(3): 340–347.Google Scholar
Liberati, A., Altman, D. G., Tetzlaff, J., Mulrow, C., Gøtzsche, P. C., Ioannidis, J. P. A.,. Clarke, M., Devereaux, P. J., Kleijnen, J., Moher, D.. (2009), ‘The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate health care interventions: explanation and elaboration’, PLoS Medicine, 6(7): e1000100.Google Scholar
Lillard, L. A., Rogowski, J. and Kington, R. (1999), ‘Insurance coverage for prescription drugs: effects on use and expenditures in the medicare population’, Medical Care, 37(9): 926–936.Google Scholar
OECD (2009), ‘Burden of out-of-pocket health expenditure’, in Health at a Glance 2009: OECD Indicators, OECD Publishing, Paris. http://www.oecd ilibrary.org/docserver/download/8111101ec054.pdf?expires=1392496758&id=id&accname=guest&checksum=1066E72E676F5CC5FD4B82D331FCFF47 Google Scholar
OECD (2013), Health at a Glance 2013: OECD Indicators, Paris: OECD Publishing. http://www.oecd-ilibrary.org/sites/health_glance-2013-en/07/04/index.html;jsessionid=3rifji9gx51.x-oecd-live-02?contentType&itemId=/content/chapter/health_glance-2013-67-en&containerItemId=/content/serial/19991312&accessItemIds=/content/book/health_glance-2013-en&mimeType=text/html Google Scholar
OECD (2015), Health at a Glance 2015: OECD Indicators, Paris: OECD Publishing. http://dx.doi.org/10.1787/health_glance-2015-en Google Scholar
OECD. Health data (web source). http://www.oecd-ilibrary.org/docserver/download/8111101ec063.pdf?expires=1388062105&id=id&accname=guest&checksum=3F94970B52BA07184258687DF4A5B98A [23 February 2016].Google Scholar
Park, H., Rascati, K. L., Lawson, K. A., Barner, J. C., Richards, K. M. and Malone, D. C. (2015), ‘Health costs and outcomes associated with medicare part D prescription drug cost-sharing in beneficiaries on dialysis’, Journal of Managed Care and Specialty Pharmacy, 21(10): 956–964.Google Scholar
Pasquale, M. K., Louder, A. M., Deminski, M. C., Chambers, R. B. and Haider, S. (2013), ‘Out-of-pocket costs and prescription reversals with oral linezolid’, American Journal of Managed Care, 19(9): 734–740.Google Scholar
Pesa, J. A., Van Den Bos, J., Gray, T., Hartsig, C., McQueen, R. B., Saseen, J. J. and Nair, K. V. (2012), ‘An evaluation of the impact of patient cost sharing for antihypertensive medications on adherence, medication and health care utilization, and expenditures’, Patient Prefer Adherence, 6: 63–72.Google Scholar
Sabaté, E. (2003), Adherence to Long-Term Therapies: Evidence for Action, Geneva: World Health Organization.Google Scholar
Soumerai, S. B., McLaughlin, T. J., Ross-Degnan, D., Casteris, C. S. and Bollini, P. (1994), ‘Effects of limiting medicaid drug-reimbursement benefits on the use of psychotropic agents and acute mental health services by patients with schizophrenia’, The New England Journal of Medicine, 331(10): 650–655.Google Scholar
Takaku, R. (2016), ‘Effects of reduced cost-sharing on children’s health: evidence from Japan’, Social Science and Medicine, 151: 46–55.Google Scholar
Wang, P. S., Patrick, A. R., Dormuth, C., Maclure, M., Avorn, J., Canning, C. F. and Schneeweiss, S. (2010), ‘Impact of drug cost sharing on service use and adverse clinical outcomes in elderly receiving antidepressants’, The Journal of Mental Health Policy and Economics, 13(1): 37–44.Google Scholar
Yang, W., Kahler, K. H., Fellers, T., Orloff, J., Chang, J., Bensimon, A. G., Wu, E. Q., Fan, C. P. and Yu, A. P. (2011), ‘Copayment level, treatment persistence, and healthcare utilization in hypertension patients treated with single-pill combination therapy’, Journal of Medical Economics, 14(3): 267–278.Google Scholar
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