Evidence map›Paper›PMID 34331213›Full record

Observational studyJournal of general internal medicine2022

Association Between Cost-Saving Prescription Policy Changes and Adherence to Chronic Disease Medications: an Observational Study.

Nancy Haff, Thomas D Sequist, Teresa B Gibson, Richele Benevent, Ellen S Sears, Sreekanth Chaguturu, Julie C Lauffenburger

Open access · bronzeAbstract readObservational Study
In one paragraph

Observational study in Journal of general internal medicine, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
0.4field-weighted citation impact, top 38% of its field
1 · What the graph read from 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.

2 · The registry

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 5 citations in OpenAlex.

  1. Article
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors at 3 institutions in 1 country.

Nancy HaffCenter for Healthcare Delivery Sciences (C4HDS) and Division of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA. nhaff@partners.org.ORCID 0000-0001-8156-7137
Thomas D SequistDivision of General Internal Medicine and Department of Health Care Policy, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA.
Teresa B GibsonIBM Watson Health, Armonk, USA.
Richele BeneventIBM Watson Health, Armonk, USA.
Ellen S SearsCenter for Healthcare Delivery Sciences (C4HDS) and Division of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA.
Sreekanth ChaguturuCVS Health, Woonsocket, RI, USA.
Julie C LauffenburgerCenter for Healthcare Delivery Sciences (C4HDS) and Division of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA.
Brigham and Women's Hospital · USIBM (United States) · USMassachusetts General Hospital · US

Funding

Development of a novel medication adherability tool to improve cardiovascular disease managementK01HL141538 · NHLBI · BRIGHAM AND WOMEN'S HOSPITAL · PI LAUFFENBURGER, JULIE CHRISTINE · 2018 to 2022
$718k
NHLBI NIH HHS K01 HL141538
6 · The paper itself

Abstract

backgroundPharmacy benefit design is one tool for improving access and adherence to medications for the management of chronic disease.

objectiveWe assessed the effects of pharmacy benefit design programs, including a change in pharmacy benefit manager (PBM), institution of a prescription out-of-pocket maximum, and a mandated switch to 90 days' medication supply, on adherence to chronic disease medications over time.

designWe used a difference-in-differences design to assess changes in adherence to chronic disease medications after the transition to new prescription policies. SUBJECTS: We utilized claims data from adults aged 18-64, on ≥ 1 medication for chronic disease, whose insurer instituted the prescription policies (intervention group) and a propensity score-matched comparison group from the same region. MAIN MEASURES: The outcome of interest was adherence to chronic disease medications measured by proportion of days covered (PDC) using pharmacy claims. KEY

resultsThere were 13,798 individuals in each group after propensity score matching. Compared to the matched control group, adherence in the intervention group decreased in the first quarter of 2015 and then increased back to pre-intervention trends. Specifically, the change in adherence compared to the last quarter of 2014 in the intervention group versus controls was - 3.6 percentage points (pp) in 2015 Q1 (p < 0.001), 0.65 pp in Q2 (p = 0.024), 1.1 pp in Q3 (p < 0.001), and 1.4 pp in Q4 (p < 0.001).

conclusionsIn this cohort of commercially insured adults on medications for chronic disease, a change in PBM accompanied by a prescription out-of-pocket maximum and change to 90 days' supply was associated with short-term disruptions in adherence followed by return to pre-intervention trends. A small improvement in adherence over the year of follow-up may not be clinically significant. These findings have important implications for employers, insurers, or health systems wishing to utilize pharmacy benefit design to improve management of chronic disease.

Indexed as

Insurance, Pharmaceutical ServicesPharmaceutical ServicesAdolescentAdultChronic DiseaseHumansMedication AdherenceMiddle AgedPolicyPrescriptionsRetrospective StudiesUnited StatesYoung Adult

Identifiers

PMID34331213
PMCPMC8858373
OpenAlexW3185830993

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

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.