Relationship of the Use and Costs of Physician Office Visits and Prescription Drugs to Travel Distance and Increases in Member Cost Share

Results of the Inclusion of New Medications in the Obligatory Health System Plan in Colombia, 2012–2013

“…It is not within the scope of this research to describe the causes of the observed increases. Factors such as accessibility to prescription without the need to provide medical justifications (the CTC), the lack of management guidelines to perform therapeutic advances, and real innovations for POS, among others, however, may have had an impact on the increased prescription of new drugs [15][16][17].…”

“…In Europe, for example, the governments are forcing pharmaceutical companies to reduce the costs of medication and have established systems with more efficient price control, have limited medications that they are willing to finance, and have established systems of copayments for users [12,[18][19][20]. Also, strategies have been implemented to modify the behavior of the prescribers, improve the quality of care, control expenses through the inclusion and dissemination of clinical practice guidelines, and perform audit with feedback and educational visits to doctors [15][16][17].…”

Determinants of physician's office visits and potential effects of co‐payments: evidence from Austria

“…On the other hand, some empirical studies found a positive relationship between travel time and the number of visits (Cecil et al . ). The authors speculate that the value of the physician's services is perceived to be greater the longer the travel distance is.…”

How Price Responsive Is the Demand for Specialty Care?

“…Cost sharing for outpatient visits has increased in tandem with medication co-payments, based on the evidence from the RAND Health Insurance Experiment and subsequent studies that demand for outpatient visits (Manning et al, 1986;Cherkin et al, 1989;Simon et al, 1996;Joyce et al, 2000;Wong et al, 2001;Cecil et al, 2006;Benedetti et al, 2008) and emergency room visits (O'Grady et al, 1985;Selby et al, 1996;Hsu et al, 2006) decreases with co-payment increases. It is not well established whether cost sharing decreases appropriate or inappropriate utilization, but increased outpatient co-payments have been associated with lower odds of receiving preventive services related to cancer (Solanki et al, 2000;Liang et al, 2004;Trivedi et al, 2008) and diabetes.…”

“…A study that examined the introduction of a $5 co-payment in a managed care setting found an insignificant (3.3%) decrease in specialty visits (Cherkin et al, 1989), whereas a study that examined the introduction of a $10 co-payment in a managed care setting found a significant 8% decrease in specialty visits (Joyce et al, 2000). A study using [2002][2003] claims data also found an inverse association between specialty visit co-payments and specialty visits (Cecil et al, 2006). A recent study of Medicare beneficiaries found that a 95% increase in primary care co-payments and a 74% increase in specialty care co-payments in [2001][2002][2003][2004][2005][2006] were associated with 20 fewer outpatient visits per 100 beneficiaries per year and that outpatient visit reductions were even more pronounced among beneficiaries with hypertension (Trivedi et al, 2010).…”