A chronic disease score from automated pharmacy data

Korff, Michael Von; Wagner, Edward H.; Saunders, Kathleen

doi:10.1016/0895-4356(92)90016-g

Cited by 854 publications

(600 citation statements)

References 8 publications

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“…51 CDS is a well-validated, pharmacy-based riskadjustment tool that uses pharmacy fill data to identify patient risk in different patient populations. [52][53][54][55][56][57][58][59][60][61][62] We refer to this measure as the risk score.…”

Section: Study Design and Study Samplementioning

confidence: 99%

Cost Sharing and Decreased Branded Oral Anti-Diabetic Medication Adherence Among Elderly Part D Medicare Beneficiaries

et al. 2013

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BACKGROUND:Although the Medicare Part D coverage gap phase-out should reduce cost-related nonadherence (CRN) among seniors with diabetes, preferential generic prescribing may have already decreased CRN, while smaller numbers of patients using more costly branded oral antidiabetic (OAD) medications remain vulnerable to CRN. OBJECTIVE: To estimate the effects of cost sharing in the Part D standard (non-LIS) benefit on adherence to different OAD classes, comparing two classes dominated by inexpensive generic medications and two by more costly branded medications. DESIGN AND PATIENTS: Retrospective cohort study using dispensed prescription data for elderly non-LIS (N= 81,047) and LIS (low-income subsidy) (N=150,359) beneficiaries using same class OAD(s) in 2008 and 2009. Logistic regression modeled non-LIS likelihood; LIS and non-LIS patients matched using propensity outcome (N= 38,054). Logistic regression, controlling for demographic and health status characteristics, modeled effects of non-LIS coverage on 2009 OAD class adherence. MAIN MEASURES: Main outcome measures were within-class OAD coverage year adherence, with patients considered adherent when days supplied to calendar days ratio at least 0.8. KEY RESULTS: Non-LIS patients had 0.52 and 0.57 times the odds of branded-only DPP-4 Inhibitor (N= 1,812; 95 % CI: 0.43, 0.63; P<0.001) and Thiazolidinedione (TZD) (N=6,290; 95 % CI: 0.52, 0.63; P<0.001) adherence. Most patients (N=32,510; 82 %) used OADs in primarily generic classes, where we found no significant (Biguanides; N=21,377) or small differences (Sulfonylureas/Glinides [N=19,240; OR: 0.91; 95 % CI: 0.86, 0.97; P =0.002]) in adherence odds. Crude adherence rates were sub-optimal when CRN was not a factor (Non-LIS/LIS: Biguanides: 65 %/65 %; Sulfonylureas/Glinides: 66 %/ 68 %; LIS: DPP-4 Inhibitors: 66 %; TZDs: 67 %). CONCLUSIONS: Gap elimination would not affect generic, but should reduce branded OAD CRN. Branded copayments may continue to lead to CRN. Policy initiatives and benefit changes targeting both cost deterrents for patients with more complex disease and non-cost generic OAD underuse are recommended.

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Section: Study Design and Study Samplementioning

confidence: 99%

Cost Sharing and Decreased Branded Oral Anti-Diabetic Medication Adherence Among Elderly Part D Medicare Beneficiaries

et al. 2013

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“…Chronic disease status was based on a chronic disease score calculated using outpatient prescription drug data in the year prior to the index date following previously established methods. 5 …”

Section: Study Populationmentioning

confidence: 99%

Patterns of pregnancy exposure to prescription FDA C, D and X drugs in a Canadian population

et al. 2008

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Objective: To examine prescription Food and Drug Administration (FDA) C, D and X drugs in general obstetric population.Study Design: Historical cohort study.Result: A total of 18 575 women who gave a birth in Saskatchewan between January 1997 and December 2000 were included. Among them, 3604 (19.4%) received FDA C, D or X drugs at least once during pregnancy. The pregnancy exposure rates were 15.8, 5.2 and 3.9%, respectively, for category C, D and X drugs, and were 11.2, 7.3 and 8.2%, respectively, in the first, second and third trimesters. Salbutamol (albuterol), trimethoprim/sulfamethoxazole (co-trimoxazole), ibuprofen, naproxen and oral contraceptives were the most common C, D, X drugs used during pregnancy.Conclusion: About one in every five women uses FDA C, D and X drugs at least once during pregnancy, and the most common prescription drugs in pregnancy are antiasthmatic, antibiotics, nonsteroid anti-inflammation drugs, antianxiety or antidepressants and oral contraceptives.

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“…The starting point for our research is the Von Korff [6] approach. This group develops the Chronic Disease Score (CDS).…”

Section: Adjusting Pharmaceutical Expenditure Backgroundmentioning

confidence: 99%

Explaining primary healthcare pharmacy expenditure using classification of medications for chronic conditions

et al. 2011

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ElsevierVivas Consuelo, DJJ.; Guadalajara Olmeda, MN.; Barrachina Martínez, I.; Poza Plaza, EDL. (2011). Explaining primary health care pharmacy expenditure using classification of medications for chronic conditions. Health Policy. 103(1):9-15. doi:10.1016/j.healthpol.2011.08.014. 1Explaining primary healthcare pharmacy expenditure using classification of medications for chronic conditions. David Vivas*, Natividad Guadalajara*, Isabel Barrachina*, José-Luis Trillo**, Ruth Usó** and Elena de-la-Poza*. AbstractBackground: The Valencian Autonomous Community (Spain) has implemented a scheme of purchasing services with the participation of public and private providers. Five districts are managed using PublicPrivate Partnership. The financing model is capitation and inter-centre invoice. The pharmaceutical benefits are not included in the per capita assignment.Objectives: Modeling and explaining pharmacy expenditure using electronic prescriptions drug data.Methods: A database of electronic prescription corresponding to 625,246 patients between Nov 2008 and Oct 2009 was used to run four linear models that explain the pharmaceutical expenditures. We take as dependent variable the neperian log of total pharmacy annual cost per patient in the primary health setting. The independent variables used combine demographics with revised classification in 18 chronic conditions obtained from the anatomical therapeutic chemical classification index (ATC).Results: The retrospective model selected included: gender, pharmaceutical co-payment status and 8 dummy variables for the number of chronic conditions of each patient from 1 to 8 or more. The goodness-of-fit achieved is measured in R 2 of 57%.Conclusions: These models must be considered in the current capitation system for pharmaceutical budgeting in a primary care setting established at regional level, as is the case in the Valencian Autonomous Community. The use of diagnostics and information regarding hospital encounters appears to be a complementary option for refining models of capitation of pharmaceutical and total health expenditure.

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A chronic disease score from automated pharmacy data

Cited by 854 publications

References 8 publications

Cost Sharing and Decreased Branded Oral Anti-Diabetic Medication Adherence Among Elderly Part D Medicare Beneficiaries

Cost Sharing and Decreased Branded Oral Anti-Diabetic Medication Adherence Among Elderly Part D Medicare Beneficiaries

Patterns of pregnancy exposure to prescription FDA C, D and X drugs in a Canadian population

Explaining primary healthcare pharmacy expenditure using classification of medications for chronic conditions

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