Utilization of Essential Medications by Vulnerable Older People After a Drug Benefit Cap: Importance of Mental Disorders, Chronic Pain, and Practice Setting
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Cites background from "Utilization of Essential Medication..."
...Studies based on claims data (6,7) as well as surveys (8,9) demonstrate that some patients cut back on medication use because of cost pressures, and cost-related medication adherence problems have been linked to serious adverse health events (6,10–14)....
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186 citations
Cites background from "Utilization of Essential Medication..."
...Fortess and coworkers (15) noted that physicians working in group practices or clinics are somewhat more able to mitigate the effects of a cap on the number of monthly prescriptions than those practicing solo or in small groups....
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...One way of possibly mitigating the effects of cost sharing on these groups would be to encourage physicians who serve large numbers of vulnerable patients to work in large group practices (15)....
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...Medicaid beneficiaries have documented decreases in the use of essential medications as a result of monthly caps on the number of allowable prescriptions (15, 20, 26)....
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...The groups analyzed were those with low income (social assistance, Medicaid, poor or near poor) (11–14, 17–24, 26–29, 31–34), those with significant health problems (poor health, chronically ill) (14, 16, 22, 25, 30), and the chronically ill poor (15)....
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...Nevertheless, the conclusions of these studies were largely invariant with respect to the study design used: cross-sectional with regression-based adjustment for differences in subject characteristics (12, 16, 25, 31); before-and-after time series, with regression controls for secular time trends and other covariates (15, 17, 20, 23, 32, 33); or time series with an external comparison group not exposed to changes in drug prices that was thought to be otherwise similar to the group that was exposed (11, 18, 21, 26, 28)....
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References
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