SynthesisPloS one2014
Association between drug insurance cost sharing strategies and outcomes in patients with chronic diseases: a systematic review.
Synthesis in PloS one, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT02579655 (Assessing Outcomes of Enhanced Chronic Disease Care Through Patient Education and a Value-based Formulary Study), which is not on this map. Cited by 37 papers, 3 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Assessing Outcomes of Enhanced Chronic Disease Care Through Patient Education and a Value-based Formulary Study
Who cites it
37 citing papers in PubMed, 3 syntheses or guidelines pooled it, 65 citations in OpenAlex.
- Pooled it
- A systematic umbrella review of the association of prescription drug insurance and cost-sharing with drug use, health services use, and health.BMC health services research · 2022Pooled it
- Medication adherence influencing factors-an (updated) overview of systematic reviews.Systematic reviews · 2019Pooled it
- Exploring patient and pharmacist perspectives on complex interventions for cardiovascular prevention: A qualitative descriptive process evaluation.Health expectations : an international journal of public participation in health care and health policy · 2020Trial
- Medicare Advantage Benefits Design and Access to Cardiovascular Care.JAMA network open · 2026Article
- Article
- Assessment of Access Barriers to Rifaximin Among Patients with Hepatic Encephalopathy Using Adjudicated Claims Data.Advances in therapy · 2025Article
- Exploring patient perspectives on the impact of resuming cost sharing: a qualitative analysis.Trials · 2024Article
- The optimal co-insurance rate for outpatient drug expenses of Iranian health insured based on the data mining method.International journal for equity in health · 2024Article
- Out-of-Pocket Costs Burden in Marketplace Plans for People With Diabetes.Health services insights · 2024Article
- The effects of patient out-of-pocket costs for insulin on medication adherence and health care utilization in patients with commercial insurance; 2007-2018.Journal of managed care & specialty pharmacy · 2022Article
- Association Between Cost-Saving Prescription Policy Changes and Adherence to Chronic Disease Medications: an Observational Study.Journal of general internal medicine · 2022Observational
- Understanding patient and physician responses to various cost-sharing programs for prescription drugs in South Korea: A multilevel analysis.Frontiers in public health · 2022Article
- Clinical Outcome and Medical Cost of Originator and Generic Antihypertensive Drugs: A Population-Based Study in Yinzhou, China.Frontiers in pharmacology · 2022Article
- Affordability of Medical Care Among Medicare Enrollees.JAMA health forum · 2021Article
- The prevalence and associated factors of nonadherence to antihypertensive medication in secondary healthcare.International urology and nephrology · 2021Article
- Differential Cost-Sharing Undermines Treatment Adherence to Combination Therapy: Evidence from Diabetes Treatment.Diabetes therapy : research, treatment and education of diabetes and related disorders · 2021Article
- Treatment Adherence in Integrative Medicine-Part One: Review of Literature.Integrative medicine (Encinitas, Calif.) · 2021Review
- The effect of pharmaceutical co-payment increase on the use of social assistance-A natural experiment study.PloS one · 2021Article
- Reasons for Nonadherence to Statins - A Systematic Review of Reviews.Patient preference and adherence · 2020Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
9 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundPrescription drugs are used in people with hypertension, diabetes, and cardiovascular disease to manage their illness. Patient cost sharing strategies such as copayments and deductibles are often employed to lower expenditures for prescription drug insurance plans, but the impact on health outcomes in these patients is unclear.
objectiveTo determine the association between drug insurance and patient cost sharing strategies on medication adherence, clinical and economic outcomes in those with chronic diseases (defined herein as diabetes, hypertension, hypercholesterolemia, coronary artery disease, and cerebrovascular disease).
methodsStudies were included if they examined various cost sharing strategies including copayments, coinsurance, fixed copayments, deductibles and maximum out-of-pocket expenditures. Value-based insurance design and reference based pricing studies were excluded. Two reviewers independently identified original intervention studies (randomized controlled trials, interrupted time series, and controlled before-after designs). MEDLINE, EMBASE, Cochrane Library, CINAHL, and relevant reference lists were searched until March 2013. Two reviewers independently assessed studies for inclusion, quality, and extracted data. Eleven studies, assessing the impact of seven policy changes, were included: 2 separate reports of one randomized controlled trial, 4 interrupted time series, and 5 controlled before-after studies.
findingsOutcomes included medication adherence, clinical events (myocardial infarction, stroke, death), quality of life, healthcare utilization, or cost. The heterogeneity among the studies precluded meta-analysis. Few studies reported the impact of cost sharing strategies on mortality, clinical and economic outcomes. The association between patient copayments and medication adherence varied across studies, ranging from no difference to significantly lower adherence, depending on the amount of the copayment.
conclusionLowering cost sharing in patients with chronic diseases may improve adherence, but the impact on clinical and economic outcomes is uncertain.
Indexed as
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What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.