IDEAS home Printed from https://ideas.repec.org/
MyIDEAS: Login to save this paper or follow this series

Benefit Plan Design and Prescription Drug Utilization Among Asthmatics: Do Patient Copayments Matter?

  • William H. Crown
  • Ernst R. Berndt
  • Onur Baser
  • Stan N. Finkelstein
  • Whitney P. Witt

Objective: The ratio of controller to reliever medication use has been proposed as a measure of treatment quality for asthma patients. In this study we examine the effects of plan level mean out-of-pocket asthma medication patient copayments and other features of benefit plan design on the use of controller medications alone, controller and reliever medications (combination therapy), and reliever medications alone. Methods: 1995-2000 MarketScan claims data were used to construct plan-level out-of-pocket copayment and physician/practice prescriber preference variables for asthma medications. Separate multinomial logit models were estimated for patients in fee-for-service (FFS) and non-FFS plans relating benefit plan design features, physician/practice prescribing preferences, patient demographics, patient comorbidities and county-level income variables to patient-level asthma treatment patterns. Results: We find that the controller reliever ratio rose steadily over 1995-2000, along with out-of-pocket payments for asthma medications, which rose more for controllers than for relievers. However, after controlling for other variables, plan level mean out-of-pocket copayments were not found to have a statistically significant influence upon patient-level asthma treatment patterns. On the other hand, physician practice prescribing patterns strongly influenced patient level treatment patterns. Conclusions: There is no strong statistical evidence that higher levels of out-of-pocket copayments for prescription drugs influence asthma treatment patterns. However, physician/practice prescribing preferences influence patient treatment.

If you experience problems downloading a file, check if you have the proper application to view it first. In case of further problems read the IDEAS help page. Note that these files are not on the IDEAS site. Please be patient as the files may be large.

File URL: http://www.nber.org/papers/w10062.pdf
Download Restriction: no

Paper provided by National Bureau of Economic Research, Inc in its series NBER Working Papers with number 10062.

as
in new window

Length:
Date of creation: Nov 2003
Date of revision:
Publication status: published as Cutler, David M. and Alan M. Garber (eds.) Frontiers in Health Policy, Vol. 7. Cambridge, MA: MIT Press for the NBER, 2004.
Handle: RePEc:nbr:nberwo:10062
Note: AG HE PE
Contact details of provider: Postal: National Bureau of Economic Research, 1050 Massachusetts Avenue Cambridge, MA 02138, U.S.A.
Phone: 617-868-3900
Web page: http://www.nber.org
Email:


More information through EDIRC

References listed on IDEAS
Please report citation or reference errors to , or , if you are the registered author of the cited work, log in to your RePEc Author Service profile, click on "citations" and make appropriate adjustments.:

as in new window
  1. Thomas F. Crossley & Paul Grootendorst & Sule Korkmaz & Michael R. Veall, 2000. "The Effects of Drug Subsidies on Out-of Pocket Prescription Drug Expenditures by Seniors: Regional Evidence from Canada," Social and Economic Dimensions of an Aging Population Research Papers 19, McMaster University.
  2. Zeckhauser, Richard, 1970. "Medical insurance: A case study of the tradeoff between risk spreading and appropriate incentives," Journal of Economic Theory, Elsevier, vol. 2(1), pages 10-26, March.
  3. Daniel Feenberg & Jonathan Skinner, 1992. "The Risk and Duration of Catastrophic Health Care Expenditures," NBER Working Papers 4147, National Bureau of Economic Research, Inc.
  4. Leibowitz, Arleen & Manning, Willard G. & Newhouse, Joseph P., 1985. "The demand for prescription drugs as a function of cost-sharing," Social Science & Medicine, Elsevier, vol. 21(10), pages 1063-1069, January.
  5. Manning, Willard G. & Marquis, M. Susan, 2001. "Health insurance: tradeoffs revisited," Journal of Health Economics, Elsevier, vol. 20(2), pages 289-293, March.
  6. P Grootendorst, 1999. "Beneficiary Cost Sharing Under Canadian Provincial Prescription Drug Benefit Programs: History and Assessment," Centre for Health Economics and Policy Analysis Working Paper Series 1999-10, Centre for Health Economics and Policy Analysis (CHEPA), McMaster University, Hamilton, Canada.
  7. Francesco Squintani, 1999. "Moral Hazard," Discussion Papers 1269, Northwestern University, Center for Mathematical Studies in Economics and Management Science.
  8. Manning, Willard G. & Marquis, M. Susan, 1996. "Health insurance: The tradeoff between risk pooling and moral hazard," Journal of Health Economics, Elsevier, vol. 15(5), pages 609-639, October.
  9. Nyman, John A., 1999. "The economics of moral hazard revisited," Journal of Health Economics, Elsevier, vol. 18(6), pages 811-824, December.
  10. Marquis, M. Susan, 1985. "Cost-sharing and provider choice," Journal of Health Economics, Elsevier, vol. 4(2), pages 137-157, June.
  11. Blomqvist, Ake, 2001. "Does the economics of moral hazard need to be revisited? A comment on the paper by John Nyman," Journal of Health Economics, Elsevier, vol. 20(2), pages 283-288, March.
Full references (including those not matched with items on IDEAS)

This item is not listed on Wikipedia, on a reading list or among the top items on IDEAS.

When requesting a correction, please mention this item's handle: RePEc:nbr:nberwo:10062. See general information about how to correct material in RePEc.

For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: ()

If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

If references are entirely missing, you can add them using this form.

If the full references list an item that is present in RePEc, but the system did not link to it, you can help with this form.

If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your profile, as there may be some citations waiting for confirmation.

Please note that corrections may take a couple of weeks to filter through the various RePEc services.

This information is provided to you by IDEAS at the Research Division of the Federal Reserve Bank of St. Louis using RePEc data.