Impact of Medicare Part D Plan Features on Use of Generic Drugs
Bibliographic Data
| ID | 9101840 |
|---|---|
| Authors | Yan Tang (0000-0003-1149-4272, University of Pittsburgh, corresponding author), Walid F Gellad (0000-0002-6992-5197, RAND Corporation), Aiju Men (University of Pittsburgh, corresponding author), Julie M Donohue (0000-0003-2418-6017, University of Pittsburgh, corresponding author) |
| Year | 2014 |
| Volume | 52 |
| Issue | 6 |
| Pages | 541-548 |
| Publication date | 2014-06-01 |
| Peer Reviewed | Yes |
| Open Access | No |
| Type | ARTICLE |
| Venue | Medical Care (JOURNAL) |
| Journal identifiers | ISSN: 0025-7079 • E-ISSN: 1537-1948 |
| Publisher | Ovid Technologies (Wolters Kluwer Health) (PUBLISHER) |
| DOI | 10.1097/mlr.0000000000000142 |
| PMID | 24824538 |
| PMCID | PMC4142208 |
| OpenAlex | W2327616456 |
| Language | EN |
| Citations received | 1 |
| References cited | 8 |
BACKGROUND: Little is known about how Medicare Part D plan features influence choice of generic versus brand drugs. OBJECTIVES: To examine the association between Part D plan features and generic medication use. METHODS: Data from a 2009 random sample of 1.6 million fee-for-service, Part D enrollees aged 65 years and above, who were not dually eligible or receiving low-income subsidies, were used to examine the association between plan features (generic cost-sharing, difference in brand and generic copay, prior authorization, step therapy) and choice of generic antidepressants, antidiabetics, and statins. Logistic regression models accounting for plan-level clustering were adjusted for sociodemographic and health status. RESULTS: Generic cost-sharing ranged from $0 to $9 for antidepressants and statins, and from $0 to $8 for antidiabetics (across 5th-95th percentiles). Brand-generic cost-sharing differences were smallest for statins (5th-95th percentiles: $16-$37) and largest for antidepressants ($16-$64) across plans. Beneficiaries with higher generic cost-sharing had lower generic use [adjusted odds ratio (OR)=0.97, 95% confidence interval (CI), 0.95-0.98 for antidepressants; OR=0.97, 95% CI, 0.96-0.98 for antidiabetics; OR=0.94, 95% CI, 0.92-0.95 for statins]. Larger brand-generic cost-sharing differences and prior authorization were significantly associated with greater generic use in all categories. Plans could increase generic use by 5-12 percentage points by reducing generic cost-sharing from the 75th ($7) to 25th percentiles ($4-$5), increasing brand-generic cost-sharing differences from the 25th ($25-$26) to 75th ($32-$33) percentiles, and using prior authorization and step therapy. CONCLUSIONS: Cost-sharing features and utilization management tools were significantly associated with generic use in 3 commonly used medication categories
Actuarial science · Business · Confidence interval · Cost sharing · Difference in differences · Drug · Economics · Generic drug · Health care · Logistic regression · Medical prescription · Medicare Advantage · Medicare Part D · Odds ratio · Percentile · Prescription drug · Prior authorization · Psychiatry · Statistics · Health Systems, Economic Evaluations, Quality of Life · Internal Medicine · Mathematics · Medication Adherence and Compliance · Medicine · Pharmaceutical Economics and Policy · Pharmacology
| Unique citing works | 1 |
|---|---|
| Citations per year | 0,2 |
| Citation span | 2021 - 2021 (1) |
| Citation velocity | historical |
| Highly cited | No |
| Citation types | Neutral: 1 |