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Impact of Medicaid Preferred Drug Lists on Therapeutic Adherence

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  • David Ridley

  • Kirsten Axelsen

Abstract

Objective: To estimate rates of non-adherence for statins following implementation of a preferred drug list (PDL). Study design: A retrospective cohort study. Methods: A difference-in-difference-in-difference approach was used to estimate the impact of a PDL on the use of statins in an Alabama Medicaid population. The PDL restricted access to certain branded medications and imposed a monthly prescription limit. The use of restricted drugs was compared with the use of unrestricted drugs in the months before and after the PDL in North Carolina (where there were no such restrictions) and Alabama. Pharmacy data from 2001 to 2005 were used to examine the effect of the Alabama PDL implemented in 2004. Results: Following the PDL in Alabama, Medicaid beneficiaries treated with statins had an 82% higher relative odds of becoming non-adherent with statin therapy compared with North Carolina and with pre-PDL Alabama [odds ratio (OR) 1.82, 95% CI 1.57, 2.11]. Furthermore, patients taking a restricted statin were more likely to be non-adherent than unrestricted patients (OR 1.42, 95% CI 1.12, 1.80). In addition, among Medicaid beneficiaries taking a restricted statin, people aged 65 years or older were more likely to be non-adherent than their younger counterparts after the PDL (OR 1.33, 95% CI 1.02, 1.73). Fifty-one per cent of patients in the Alabama sample were non-adherent with statin therapy after the PDL, compared with 39% before. Non-adherence was 36% in North Carolina in both periods. Conclusion: The management of heart disease and high cholesterol are important challenges, especially for low-income patients. Policy makers should be aware that access restrictions can have adverse consequences for patient adherence. Copyright Adis Data Information BV 2006

Suggested Citation

  • David Ridley & Kirsten Axelsen, 2006. "Impact of Medicaid Preferred Drug Lists on Therapeutic Adherence," PharmacoEconomics, Springer, vol. 24(3), pages 65-78, December.
    • Handle: RePEc:spr:pharme:v:24:y:2006:i:3:p:65-78
    DOI: 10.2165/00019053-200624003-00006
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    Cited by:

    1. Natt Hongdilokkul & Emanuel Krebs & Xiao Zang & Haoxuan Zhou & Fahmida Homayra & Jeong Eun Min & Bohdan Nosyk, 2021. "The effect of British Columbia's Pharmacare coverage expansion for opioid agonist treatment," Health Economics, John Wiley & Sons, Ltd., vol. 30(5), pages 1222-1238, May.
    2. Alvin Headen, 2006. "Medicaid Preferred Drug Lists: Cost Containment and Side Effects," PharmacoEconomics, Springer, vol. 24(3), pages 1-3, December.
    3. David B. Ridley, 2015. "Payments, Promotion, And The Purple Pill," Health Economics, John Wiley & Sons, Ltd., vol. 24(1), pages 86-103, January.
    4. Vincenzo Atella & Joanna Kopinska, 2012. "The impact of cost sharing schemes on drug compliance: evidence based on quantile regression," CEIS Research Paper 247, Tor Vergata University, CEIS, revised 27 Jul 2012.

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