Dennis Ross-Degnan
Dados Biográficos
| ID | 1727635 |
|---|---|
| NOME | Dennis Ross-Degnan |
| PRENOMES | Dennis |
| SOBRENOME | Ross-Degnan |
| ASSINATURA | ROSS-DEGNAN D |
| AFILIAÇÕES | Harvard University |
| ORCID | 0000-0002-0066-1242 |
| VERIFICADO | Sim |
| TOTAL DE OBRAS | 42 |
| TOTAL DE CITAÇÕES | 46 |
| TOTAL COMO AUTOR | 42 |
| TOTAL COMO EDITOR | 0 |
| PRIMEIRO ANO DE PUBLICAÇÃO | 1983 |
| ANO MAIS RECENTE DE PUBLICAÇÃO | 2025 |
| ÍNDICE H | 5 |
Preventive Drug Lists Reduce Income-Related Disparities in Medication Adherence Over 2 Years
BACKGROUND: Employers add Preventive Drug Lists (PDLs) to commercial insurance plans to reduce out-of-pocket payments for medicines that treat important chronic illnesses. OBJECTIVE: This study examined the impact of PDLs among patients with pre-existing diabetes. RESEARCH DESIGN: Interrupted time series design with difference-in-difference analysis. SUBJECTS: We identified 5575 patients aged 12-64 with diabetes whose employers adopted PDL covera…
Acute Diabetes Complications After Transition to a Value-Based Medication Benefit
In this cohort study, acute, preventable diabetes complication days decreased by 8.4% in the overall PDL group and by 10.2% among PDL members from lower-income areas compared with the control group. The results may support a strategy of incentivizing adoption of targeted cost-sharing reductions among commercially insured patients with diabetes and lower income to enhance health outcomes
The effectiveness of training strategies to improve healthcare provider practices in low-income and middle-income countries
INTRODUCTION: In low/middle-income countries (LMICs), training is often used to improve healthcare provider (HCP) performance. However, important questions remain about how well training works and the best ways to design training strategies. The objective of this study is to characterise the effectiveness of training strategies to improve HCP practices in LMICs and identify attributes associated with training effectiveness. METHODS: We performed …
Affordability of Medical Care Among Medicare Enrollees
The findings of this study suggest that unaffordability of medical care is common among Medicare enrollees, especially those with lower incomes, or worse health, or who qualify for Medicare based on disability. Policy reforms, such as caps on patient spending, are needed to reduce Medical cost burdens on the most vulnerable enrollees
Cost-related Medication Nonadherence and Its Risk Factors Among Medicare Beneficiaries
BACKGROUND: Unaffordability of medications is a barrier to effective treatment. Cost-related nonadherence (CRN) is a crucial, widely used measure of medications access. OBJECTIVES: Our study examines the current national prevalence of and risk factors for CRN (eg, not filling, skipping or reducing doses) and companion measures in the US Medicare population. RESEARCH DESIGN: Survey-weighted analyses included logistic regression and trends 2006-201…
Hypertension and diabetes treatment affordability and government expenditures following changes in patient cost sharing in the “Farmácia popular” program in Brazil
FP rapidly increased its coverage in terms of both program reach and proportion of cost subsidized during the period analyzed. Costs of individual HTN and DM treatments in FP were reduced after 2011 for both patients (free) and government (better negotiated prices). However, overall FP expenditures by MoH increased due to markedly increased utilization. The FP is sustainable as a complementary policy but cannot feasibly substitute for the distrib…
Reduced Cost-sharing for Preventive Drugs Preferentially Benefits Low-income Patients With Diabetes in High Deductible Health Plans With Health Savings Accounts
BACKGROUND: High deductible health plans linked to Health Savings Accounts (HSA-HDHPs) must include all care under the deductible except for select preventive services. Some employers and insurers have adopted Preventive Drug Lists (PDLs) that exempt specific classes of medications from deductibles. OBJECTIVE: The objective of this study was to examine the association between shifts to PDL coverage and medication utilization among patients with d…
Brazilian generics market change after Farmácia Popular program
OBJECTIVE: To evaluate trends in the use of generic and non-generic medicines to treat hypertension and diabetes under the Farmácia Popular Program (FP) and its impact on generic medicines sales volume and market share in the Brazilian pharmaceutical market. METHODS: This longitudinal, retrospective study used interrupted time series design to analyze changes in monthly sales volume and proportion of medicines sales (market share) for oral antidi…
Effectiveness of strategies to improve health-care provider practices in low-income and middle-income countries
Trends and Disparities in Sexual and Reproductive Health Behaviors and Service Use Among Young Adult Women (Aged 18–25 Years) in the United States, 2002–2015
Objectives. To describe trends in sexual and reproductive health behaviors and service utilization among young women in the United States. Methods. We analyzed data from 8835 female respondents aged 18 to 25 years from 4 cycles of the National Survey of Family Growth, a nationally representative cross-sectional survey, from 2002 to 2015. We used bivariate and multivariable logistic regression to compare rates of self-reported sexual activity, sex…
Essential medicines for universal health coverage
Farmácia Popular Program
This paper aims to analyse changes in the retail pharmaceutical market following policy changes in the Farmácia Popular Program (FP), a medicines subsidy program in Brazil. The retrospective longitudinal analyses focus on therapeutic class of agents acting on the renin-angiotensin system. Data obtained from QuintilesIMS (formerly IMS Health) included private retail pharmacy sales volume (pharmaceutical units) and sales values from 2002 to 2013. A…
Colorectal Cancer Screening in a Nationwide High-deductible Health Plan Before and After the Affordable Care Act
BACKGROUND: Little is known about the effect of the Affordable Care Act's (ACA) elimination of out-of-pocket costs for preventive services. This policy likely reduced out-of-pocket colonoscopy costs most for high-deductible health plan (HDHP) members. OBJECTIVES: Determine the ACA's impact on colorectal cancer screening among HDHP members. RESEARCH DESIGN: Pre-post with comparison group, constructed before and after the ACA. SUBJECTS: We studied …
Barriers in household access to medicines for chronic conditions in three Latin American countries
The nature of the health system plays an important role in access to medicines. Access is better when public facilities are available and function effectively, or when private sector care is affordable. Thus, understanding how people seek care in a given setting and strengthening key health system components will be important strategies to improve access to medicines, especially for populations at high risk of poor access
Evidence on access to medicines for chronic diseases from household surveys in five low- and middle-income countries
The 2011 United Nations (UN) General Assembly Political Declaration on Prevention and Control of Non-Communicable Diseases (NCDs) brought NCDs to the global health agenda. Essential medicines are central to treating chronic diseases such as hypertension and diabetes. Our study aimed to quantify access to essential medicines for people with chronic conditions in five low- and middle-income countries and to evaluate how household socioeconomic stat…
Improving adherence to antiretroviral treatment in Uganda with a low-resource facility-based intervention
OBJECTIVE: To assess the effects of facility-based interventions using existing resources to improve overall patient attendance and adherence to antiretroviral therapy (ART) at ART-providing facilities in Uganda. METHODS: This was an interventional study which tracked attendance and treatment adherence of two distinct cohorts: experienced patients who had been on treatment for at least 12 months prior to the intervention and patients newly initia…
Impact of pharmaceutical policy interventions on utilization of antipsychotic medicines in Finland and Portugal in times of economic recession
Different policy approaches to contain pharmaceutical expenditures in times of the economic recession in Finland and Portugal had intended--increased use of generics--and likely unintended--slightly decreased overall sales, possibly consistent with decreased access to needed medicines--impacts. These findings highlight the importance of monitoring and evaluating the effects of pharmaceutical policy interventions on use of medicines and health out…
Impact of a High-deductible Health Plan on Outpatient Visits and Associated Diagnostic Tests
BACKGROUND: By shifting a greater share of out-of-pocket medical costs to consumers, high-deductible health plans (HDHP) might discourage use of essential outpatient services. OBJECTIVE: The objective of the study was to examine the impact of an HDHP on outpatient visits and associated laboratory and radiology tests. RESEARCH DESIGN/SUBJECTS: We used a pre-post with comparison group study design to examine the differential change in outpatient se…
Persistent Medication Affordability Problems Among Disabled Medicare Beneficiaries After Part D, 2006–2011
BACKGROUND: Disabled Americans who qualify for Medicare coverage typically have multiple chronic conditions, are highly dependent on effective drug therapy, and have limited financial resources, putting them at risk for cost-related medication nonadherence (CRN). Since 2006, the Part D benefit has helped Medicare beneficiaries afford medications. OBJECTIVE: To investigate recent national trends in medication affordability among this vulnerable po…
Changes in Use of Lipid-lowering Medications Among Black and White Dual Enrollees With Diabetes Transitioning From Medicaid to Medicare Part D Drug Coverage
BACKGROUND: The use of lipid-lowering agents is suboptimal among dual enrollees, particularly blacks. OBJECTIVES: To determine whether the removal of restrictive drug caps under Medicare Part D reduced racial differences among dual enrollees with diabetes. RESEARCH DESIGN: An interrupted time series with comparison series design (ITS) cohort study. SUBJECTS: A total of 8895 black and white diabetes patients aged 18 years and older drawn from a na…
Health care payments in the asia pacific
Studies that examine economic burden attributable to health care payments should include measures of impoverishment and indebtedness
Access to medicines for acute illness in middle income countries in Central America
OBJECTIVE: To analyze the main predictors of access to medicines for persons who experienced acute health conditions. METHODS: This was a cross-sectional analytic study, based on data from household surveys. We examined the predictors of: (1) seeking care for acute illness in the formal health care system and (2) obtaining all medicines sought for the acute condition. RESULTS: The significant predictors of seeking health care for acute illnesses …
Household Expenditures for Medicines and the Role of Free Medicines in the Brazilian Public Health System
Objectives. We sought to investigate, across different socioeconomic groups, the proportion of household medicine expenses that were paid by households and the proportion paid by the Brazilian national health system. Methods. We carried out a survey in Porto Alegre, Brazil, that included 2988 individuals of all ages. We defined 2 expenditure variables: “out-of-pocket medicines value” (the sum of retail prices of all medicines used by family membe…
Two-year Trends in Colorectal Cancer Screening After Switch to a High-deductible Health Plan
BACKGROUND: Recent health reform laws might accelerate high-deductible health plan (HDHP) growth. The impact of HDHPs on long-term colorectal cancer screening rates and low socioeconomic status (SES) members is unknown. METHODS: We studied colorectal cancer screening rates among 1306 Health Maintenance Organization (HMO) members for 1 year before and 2 years after an employer-mandated switch to HDHPs, compared with 1306 propensity score-matched c…
Medicare Part D and Changes in Prescription Drug Use and Cost Burden
CONTEXT: The full effect of Medicare Part D, after the initial policy transition period and across the United States Medicare population, remains unclear. OBJECTIVE: To estimate nationally representative changes in prescription drug use and out-of-pocket drug costs 2 years after implementation of Part D. DESIGN, SETTING, AND PARTICIPANTS: We examined study outcomes over 8 years (2000 to 2007) and estimated changes after Part D, accounting for ear…
Retail pharmacies in developing countries
A strategy for promoting improved pharmaceutical use
The impact of face-to-face educational outreach on diarrhoea treatment in pharmacies
Private pharmacies are an important source of health care in developing countries. A number of studies have documented deficiencies in treatment, but little has been done to improve practices. We conducted two controlled trials to determine the efficacy of face-to-face educational outreach in improving communication and product sales for cases of diarrhoea in children in 194 private pharmacies in two developing countries. A training guide was dev…
Evidence on access to medicines for chronic diseases from household surveys in five low- and middle-income countries
The 2011 United Nations (UN) General Assembly Political Declaration on Prevention and Control of Non-Communicable Diseases (NCDs) brought NCDs to the global health agenda. Essential medicines are central to treating chronic diseases such as hypertension and diabetes. Our study aimed to quantify access to essential medicines for people with chronic conditions in five low- and middle-income countries and to evaluate how household socioeconomic stat…
Household Expenditures for Medicines and the Role of Free Medicines in the Brazilian Public Health System
Objectives. We sought to investigate, across different socioeconomic groups, the proportion of household medicine expenses that were paid by households and the proportion paid by the Brazilian national health system. Methods. We carried out a survey in Porto Alegre, Brazil, that included 2988 individuals of all ages. We defined 2 expenditure variables: “out-of-pocket medicines value” (the sum of retail prices of all medicines used by family membe…
Antibiotic use following a Korean national policy to prohibit medication dispensing by physicians
This study investigated whether a Korean national policy prohibiting doctors from dispensing drugs as of 2000 selectively reduced inappropriate antibiotic prescribing in viral illness compared with bacterial illness. We assessed the proportions of episodes prescribed an antibiotic and the number of different antibiotics prescribed for patients with viral and bacterial illness episodes before and after the policy. The nationally representative sam…
Access to medicines for acute illness in middle income countries in Central America
OBJECTIVE: To analyze the main predictors of access to medicines for persons who experienced acute health conditions. METHODS: This was a cross-sectional analytic study, based on data from household surveys. We examined the predictors of: (1) seeking care for acute illness in the formal health care system and (2) obtaining all medicines sought for the acute condition. RESULTS: The significant predictors of seeking health care for acute illnesses …
Trends and Disparities in Sexual and Reproductive Health Behaviors and Service Use Among Young Adult Women (Aged 18–25 Years) in the United States, 2002–2015
Objectives. To describe trends in sexual and reproductive health behaviors and service utilization among young women in the United States. Methods. We analyzed data from 8835 female respondents aged 18 to 25 years from 4 cycles of the National Survey of Family Growth, a nationally representative cross-sectional survey, from 2002 to 2015. We used bivariate and multivariable logistic regression to compare rates of self-reported sexual activity, sex…
Field methodology for ocular surveys in rural Africa
A strategy for promoting improved pharmaceutical use
The impact of face-to-face educational outreach on diarrhoea treatment in pharmacies
Private pharmacies are an important source of health care in developing countries. A number of studies have documented deficiencies in treatment, but little has been done to improve practices. We conducted two controlled trials to determine the efficacy of face-to-face educational outreach in improving communication and product sales for cases of diarrhoea in children in 194 private pharmacies in two developing countries. A training guide was dev…
Retail pharmacies in developing countries
Undercover careseekers
Shifting Physician Prescribing to a Preferred Histamine-2-Receptor Antagonist
OBJECTIVES: This study was undertaken to determine whether a program of education, therapeutic reevaluation of eligible patients, and performance feedback could shift prescribing to cimetidine from other histamine-2 receptor antagonists, which commonly are used in the management of ulcers and reflux, and reduce costs without increasing rates of ulcer-related hospital admissions. METHODS: This study used an interrupted monthly time series with com…
Segmented regression analysis of interrupted time series studies in medication use research
Interrupted time series design is the strongest, quasi-experimental approach for evaluating longitudinal effects of interventions. Segmented regression analysis is a powerful statistical method for estimating intervention effects in interrupted time series studies. In this paper, we show how segmented regression analysis can be used to evaluate policy and educational interventions intended to improve the quality of medication use and/or contain c…
Antibiotic use following a Korean national policy to prohibit medication dispensing by physicians
This study investigated whether a Korean national policy prohibiting doctors from dispensing drugs as of 2000 selectively reduced inappropriate antibiotic prescribing in viral illness compared with bacterial illness. We assessed the proportions of episodes prescribed an antibiotic and the number of different antibiotics prescribed for patients with viral and bacterial illness episodes before and after the policy. The nationally representative sam…
Racial Differences in Impact of Coverage on Diabetes Self-Monitoring in a Health Maintenance Organization
BACKGROUND: Insurance coverage of patient self-management devices like self-monitoring blood glucose (SMBG) equipment may help to reduce race-related barriers to effective care. OBJECTIVES: We examined whether providing free home glucose monitors had greater impacts on self-monitoring among black versus white patients with diabetes. RESEARCH DESIGN: Using electronic medical record data (1992-1996), we used longitudinal survival analysis to examin…
Trends and Geographic Variation of Opiate Medication Use in State Medicaid Fee-For-Service Programs, 1996 to 2002
BACKGROUND: Although studies have documented hospital and surgical service geographic variability, prescription use geographic variability is largely unknown. Opiate pain medications are widely used, particularly because the promulgation of clinical guidelines promoting aggressive pain treatment. This study describes temporal and interstate variability in aggregate prescription opiate medication use within U.S. Medicaid programs. METHODS: A datas…
Differential Effect of Early or Late Implementation of Prior Authorization Policies on the Use of Cox II Inhibitors
BACKGROUND: State Medicaid programs introduce many types of prescribing restrictions to manage pharmaceutical use and expenditure. Little is known about the differential effect of implementing prior authorization (PA) policies at market entry versus waiting until several years later when prescribing behavior may already be established. OBJECTIVES: We sought to examine the impact on overall use of Cox II inhibitors of PA policies implemented at ma…
Medicaid Prior Authorization and Controlled-Release Oxycodone
BACKGROUND: Since its introduction in 1996, controlled-release (CR) oxycodone use has increased steadily despite its high cost. To control use and expenditures, many Medicaid programs have implemented CR oxycodone prior authorization (PA) policies. Few studies evaluate Medicaid policies or compare lenient and strict policies in multiple states. OBJECTIVE: To estimate the impact of PA on CR oxycodone use by Medicaid beneficiaries. DESIGN: Secondar…
Reliability of New Measures of Cost-Related Medication Nonadherence
BACKGROUND: Although several national studies have attempted to measure medication nonadherence due to cost in cross-sectional studies of the elderly and disabled, little information exists on the psychometric properties of these measures over time. OBJECTIVES: Examine the test-retest reliability of several recently published measures of cost-related medication nonadherence, among elderly community. METHODS: We developed a questionnaire and teste…
Medicine prices, availability, and affordability in 36 developing and middle-income countries
Measuring medicine prices in Peru
The WHO/HAI survey approach strikes an appropriate balance between modest research costs and optimal information for policy. Focusing on commonly used medicines yields sufficient and valid results. Surveyors elsewhere should consider the limits of the survey data as well as any local circumstances, such as scarcity, that may call for extra field efforts
Out-of-Pocket Burden of Health Care Spending and the Adequacy of the Medicare Part D Low-Income Subsidy
BACKGROUND: Evaluating the adequacy of Medicare prescription drug program (Part D) and its low-income subsidy (LIS) requires a comprehensive understanding of drug spending in relation to household resources. OBJECTIVE: : To estimate out-of-pocket health care costs in the year before Part D, in context of total household spending, health status, and LIS eligibility. RESEARCH DESIGN: Nationally representative cross-sectional study. SUBJECTS: Two th…
Unintended Impacts of a Medicaid Prior Authorization Policy on Access to Medications for Bipolar Illness
OBJECTIVES: Prior authorization policies (PA) are widely used to control psychotropic medication costs by state Medicaid programs and Medicare Part D plans. The objective of this study was to examine the impact of a Maine Medicaid PA policy on initiation and switching of anticonvulsant and atypical antipsychotic treatments among patients with bipolar disorder. METHODS: We obtained Maine and New Hampshire (comparison state) Medicaid and Medicare c…
Household Expenditures for Medicines and the Role of Free Medicines in the Brazilian Public Health System
Objectives. We sought to investigate, across different socioeconomic groups, the proportion of household medicine expenses that were paid by households and the proportion paid by the Brazilian national health system. Methods. We carried out a survey in Porto Alegre, Brazil, that included 2988 individuals of all ages. We defined 2 expenditure variables: “out-of-pocket medicines value” (the sum of retail prices of all medicines used by family membe…
Two-year Trends in Colorectal Cancer Screening After Switch to a High-deductible Health Plan
BACKGROUND: Recent health reform laws might accelerate high-deductible health plan (HDHP) growth. The impact of HDHPs on long-term colorectal cancer screening rates and low socioeconomic status (SES) members is unknown. METHODS: We studied colorectal cancer screening rates among 1306 Health Maintenance Organization (HMO) members for 1 year before and 2 years after an employer-mandated switch to HDHPs, compared with 1306 propensity score-matched c…
Medicare Part D and Changes in Prescription Drug Use and Cost Burden
CONTEXT: The full effect of Medicare Part D, after the initial policy transition period and across the United States Medicare population, remains unclear. OBJECTIVE: To estimate nationally representative changes in prescription drug use and out-of-pocket drug costs 2 years after implementation of Part D. DESIGN, SETTING, AND PARTICIPANTS: We examined study outcomes over 8 years (2000 to 2007) and estimated changes after Part D, accounting for ear…
Health care payments in the asia pacific
Studies that examine economic burden attributable to health care payments should include measures of impoverishment and indebtedness
Access to medicines for acute illness in middle income countries in Central America
OBJECTIVE: To analyze the main predictors of access to medicines for persons who experienced acute health conditions. METHODS: This was a cross-sectional analytic study, based on data from household surveys. We examined the predictors of: (1) seeking care for acute illness in the formal health care system and (2) obtaining all medicines sought for the acute condition. RESULTS: The significant predictors of seeking health care for acute illnesses …
Improving adherence to antiretroviral treatment in Uganda with a low-resource facility-based intervention
OBJECTIVE: To assess the effects of facility-based interventions using existing resources to improve overall patient attendance and adherence to antiretroviral therapy (ART) at ART-providing facilities in Uganda. METHODS: This was an interventional study which tracked attendance and treatment adherence of two distinct cohorts: experienced patients who had been on treatment for at least 12 months prior to the intervention and patients newly initia…
Impact of pharmaceutical policy interventions on utilization of antipsychotic medicines in Finland and Portugal in times of economic recession
Different policy approaches to contain pharmaceutical expenditures in times of the economic recession in Finland and Portugal had intended--increased use of generics--and likely unintended--slightly decreased overall sales, possibly consistent with decreased access to needed medicines--impacts. These findings highlight the importance of monitoring and evaluating the effects of pharmaceutical policy interventions on use of medicines and health out…
Impact of a High-deductible Health Plan on Outpatient Visits and Associated Diagnostic Tests
BACKGROUND: By shifting a greater share of out-of-pocket medical costs to consumers, high-deductible health plans (HDHP) might discourage use of essential outpatient services. OBJECTIVE: The objective of the study was to examine the impact of an HDHP on outpatient visits and associated laboratory and radiology tests. RESEARCH DESIGN/SUBJECTS: We used a pre-post with comparison group study design to examine the differential change in outpatient se…
Medicine (39 obras) · Business (20 obras) · Environmental health (19 obras) · Health care (18 obras) · Medication Adherence and Compliance (16 obras) · Nursing (15 obras) · Pharmaceutical Economics and Policy (15 obras) · Health Systems, Economic Evaluations, Quality of Life (14 obras) · Economic growth (13 obras) · Economics (13 obras)