PMID- 12618643
OWN - NLM
STAT- MEDLINE
DCOM- 20030327
LR  - 20131121
IS  - 0025-7079 (Print)
IS  - 0025-7079 (Linking)
VI  - 41
IP  - 3
DP  - 2003 Mar
TI  - Effect of tiered prescription copayments on the use of preferred brand 
      medications.
PG  - 398-406
AB  - BACKGROUND AND OBJECTIVE: Health plans are increasingly using more open drug 
      formularies that offer differential prescription copayments as an incentive to 
      enrollees to use brands that plans prefer. How much this financial incentive 
      affects use of preferred brands has not been widely reported. The aim of this 
      study was to estimate the effect of tiered copayments on the choice between 
      preferred and nonpreferred brand medications. MATERIALS AND METHODS: Longitudinal 
      logistic regression analyses of pharmacy claims from 1998 and 1999 comparing 
      concurrent groups that were or were not exposed to tiered copayments. SUBJECTS: 
      Enrollees in four independent physician practice association model health plans 
      who had pharmacy claims for angiotensin converting enzyme inhibitors (ACEI), 
      proton pump inhibitors (PPI), or hydroxymethylglutaryl coenzyme A reductase 
      inhibitors (STATINS). OUTCOME MEASURE: Change in the percentage of prescription 
      claims that were for preferred brands. MAIN RESULTS: Regression adjusted 
      estimates of the average net increase in the percentage use of preferred brands 
      of ACEI, PPI and STATIN from first quarter 1998 to third quarter 1999 attributed 
      to tiered prescription copayments were 13.3 (P = 0.001), 8.9 (P = 0.03), and 6.0 
      (P <0.001) percentage points, respectively. CONCLUSIONS: Tiered prescription 
      copayments were associated with a significant shift from nonpreferred to 
      preferred brand medications. This type of financial incentive can help purchasers 
      providing open access drug benefits by steering use of medications toward lower 
      cost brands. The clinical effects of changes in medication use brought about 
      differential copayments warrant further investigation.
FAU - Rector, Thomas S
AU  - Rector TS
AD  - Center for Health Care Policy and Evaluation, UnitedHealth Group, Eden Prairie, 
      Minnesota 55344, USA. thomas_s_rector@uhc.com
FAU - Finch, Michael D
AU  - Finch MD
FAU - Danzon, Patricia M
AU  - Danzon PM
FAU - Pauly, Mark V
AU  - Pauly MV
FAU - Manda, Bharati S
AU  - Manda BS
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PL  - United States
TA  - Med Care
JT  - Medical care
JID - 0230027
RN  - 0 (Angiotensin-Converting Enzyme Inhibitors)
RN  - 0 (Hydroxymethylglutaryl-CoA Reductase Inhibitors)
RN  - 0 (Proton Pump Inhibitors)
RN  - 0 (Proton Pumps)
SB  - IM
MH  - Aged
MH  - Angiotensin-Converting Enzyme Inhibitors/classification/economics
MH  - *Cost Sharing
MH  - Female
MH  - *Formularies as Topic
MH  - Health Services Research
MH  - Humans
MH  - Hydroxymethylglutaryl-CoA Reductase Inhibitors/classification/economics
MH  - Independent Practice Associations/*economics/organization & administration
MH  - *Insurance, Pharmaceutical Services
MH  - Longitudinal Studies
MH  - Male
MH  - Middle Aged
MH  - Patient Satisfaction/*economics
MH  - Prescription Fees
MH  - Proton Pump Inhibitors
MH  - Proton Pumps/economics
MH  - Regression Analysis
MH  - Therapeutic Equivalency
MH  - United States
EDAT- 2003/03/06 04:00
MHDA- 2003/03/28 05:00
CRDT- 2003/03/06 04:00
PHST- 2003/03/06 04:00 [pubmed]
PHST- 2003/03/28 05:00 [medline]
PHST- 2003/03/06 04:00 [entrez]
AID - 10.1097/01.MLR.0000053022.47132.82 [doi]
PST - ppublish
SO  - Med Care. 2003 Mar;41(3):398-406. doi: 10.1097/01.MLR.0000053022.47132.82.