Evidence map›Paper›PMID 35466402›Full record

ArticleHealth services research2022

The diabetes health plan and medication adherence among individuals with low incomes.

Kimberly Danae Cauley Narain, Norman Turk, O Kenrik Duru, Tannaz Moin, Sam Ho, Carol M Mangione

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Health services research, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
–field-weighted citation impact
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

4 citing papers in PubMed.

  1. Trial
  2. Article
  3. Article
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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

6 authors.

Kimberly Danae Cauley NarainDivision of General Internal Medicine and Health Services Research, Department of Medicine, David Geffen School of Medicine, University of California, Los Angeles, California, USA.ORCID 0000-0001-8548-1728
Norman TurkDivision of General Internal Medicine and Health Services Research, Department of Medicine, David Geffen School of Medicine, University of California, Los Angeles, California, USA.
O Kenrik DuruDivision of General Internal Medicine and Health Services Research, Department of Medicine, David Geffen School of Medicine, University of California, Los Angeles, California, USA.
Tannaz MoinDivision of General Internal Medicine and Health Services Research, Department of Medicine, David Geffen School of Medicine, University of California, Los Angeles, California, USA.ORCID 0000-0002-5035-6641
Sam HoUnitedHealthcare, Minnetonka, Minnesota, USA.
Carol M MangioneDivision of General Internal Medicine and Health Services Research, Department of Medicine, David Geffen School of Medicine, University of California, Los Angeles, California, USA.

Funding

The Center for Health Improvement of Minority ElderlyP30AG021684 · NIA · UNIVERSITY OF CALIFORNIA LOS ANGELES · PI OBIDIUGWU KENRIK DURU, CAROL M MANGIONE · 2002 to 2026
$19.7M
The Diabetes Health Plan: A System Level Intervention to Prevent & Treat DiabetesU58DP002722 · DP · UNIVERSITY OF CALIFORNIA LOS ANGELES · PI MANGIONE, CAROL M · 2010 to 2014
$2.5M
A Partnered Evaluation of UHC Medicaid Plan Innovations for Diabetes PatientsU18DP006128 · DP · UNIVERSITY OF CALIFORNIA LOS ANGELES · PI DURU, OBIDIUGWU KENRIK, MANGIONE, CAROL M · 2015 to 2019
$2.3M
The Implications of Insurance Benefit Design for Health and Disability Among Low Income Adults with Diabetes.K08AG068372 · NIA · UNIVERSITY OF CALIFORNIA LOS ANGELES · PI NARAIN, KIMBERLY D · 2020 to 2024
$887k
NCCDPHP CDC HHS U18 DP006128NCCDPHP CDC HHS U58 DP002722NIA NIH HHS K08 AG068372NIA NIH HHS P30 AG021684
6 · The paper itself

Abstract

objectiveTo test the impact of the Diabetes Health Plan (DHP), a diabetes-specific insurance plan that lowers out-of-pocket costs for diabetes-related medications and clinical visits, on adherence to oral hypoglycemic medications among low-income adults with Type 2 Diabetes (T2DM). DATA SOURCES AND STUDY

settingCohort of adults (18-64) with T2DM, an annual household income <USD 30,000, and who were continuously enrolled in an employer-sponsored UnitedHealthcare plan for at least two years between 2009 and 2014. STUDY

designWe employed a linear regression Difference-In-Differences (DID) approach with a matched comparison group. To assess for differential DHP effects across adherent versus non-adherent patients, we ran a Difference-in-Difference-in-Differences (DDD) analysis by including an interaction term that included indicators for DHP exposure status and time, and low versus high baseline medication adherence. DATA COLLECTION: The analytic data set is limited to employer groups that purchased the DHP and standard benefit plans from UnitedHealthcare, had internal pharmacy contracts; complete pharmacy claims data, and sufficient medical claims and lab data to identify employees and their dependents with T2DM. PRINCIPAL

findingsOur DID analysis did not show improved medication adherence associated with employer DHP adoption. However, the DDD model suggested a difference between DHP-exposed and comparison beneficiaries when comparing the relative effect on individuals who were adherent versus non-adherent at baseline, as suggested by the significant three-way interaction term (10.2,p = 0.028). This effect was driven by the 8.2 percentage point increase in medication adherence for the DHP subsample that was non-adherent at baseline.

conclusionsThe DHP may benefit low-income patients with low baseline medication adherence. Value-based insurance design may be an important strategy for mitigating income disparities in T2DM outcomes.

Indexed as

Diabetes Mellitus, Type 2Pharmaceutical ServicesAdultCohort StudiesHumansHypoglycemic AgentsMedication AdherenceRetrospective StudiesHypoglycemic Agentsdiabeteshealth disparitieshealth equitylow-incomemedication non-adherencevalue based insurance design

Identifiers

PMID35466402
PMCPMC9660410

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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.