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July 3, 2007 (Insidermedicine) Prescription drug cost-sharing is associated with a decrease in drug spending and use of pharmacies, and in some cases, increased use of expensive medical services, according to a report published in the Journal of the American Medical Association.
Over the last several decades, access to outpatient drugs in the US has become a cornerstone of an efficient healthcare system. More and more people have access to better quality prescription drugs, which improves overall health and quality of life. However, given the rising costs of medicine, many pharmaceutical benefit managers have shifted the costs of drugs back to the patients in the form of co-payment. This, in essence, results in the cost of the drug being shared between the plan and the patient.
To determine how cost-sharing strategies used by drug benefit plans may affect access to prescription drugs and thereby affects medical spending and health outcomes, researchers analyzed more than 130 published studies on prescription drug cost-containment measures and health outcomes.
They found that increased cost sharing is associated with lower use of prescription drugs, decreased adherence, and more frequent discontinuation of therapy. For each 10% increase in cost sharing, prescription drug spending decreases by 2 to 6%, depending on the type of drug and the health of the patient.
But decreased drug use doesn’t necessarily result in healthcare savings. For some chronic conditions such as congestive heart failure, diabetes, and schizophrenia, cost sharing is associated with increased use of medical services. This results in added cost and social burden to an already stressed healthcare system.
To remedy the situation, patients become more sensitive to the cost of treatment while at the same time be encouraged them to use cost-effective care. This will involve knowing how patients respond to different incentives and being able to provide the most effective and affordable therapies.
Reporting for Insidermedicine, I'm Dr. Susan Sharma.
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