Retrospective Evaluation of the Impact of Copayment Increases for Specialty Medications on Adherence and Persistence in an Integrated Health Maintenance Organization System

Impact of Cost‐Sharing Increases on Continuity of Specialty Drug Use: A Quasi‐Experimental Study

“…Furthermore, the magnitude of our findings was greater than those found in prior studies, which have primarily captured the experience of privately insured patients from a time period when very few patients were subject to aggressive cost-sharing strategies for specialty drugs (Ozminkowski et al 2004;Goldman et al 2006;Curkendall et al 2008;Lafata et al 2008;Gleason et al 2009;Karaca-Mandic et al 2010;Kim et al 2011;Palmer et al 2012;Romley et al 2012;Desai et al 2014;Starner et al 2014). Those studies documented that higher cost sharing appeared to have a stronger impact on noninitiation or abandonment of prescriptions at the pharmacy but minimal impact (as measured by refill behavior, adherence, and discontinuation) once patients decided to initiate therapy (Ozminkowski et al 2004;Goldman et al 2006;Curkendall et al 2008;Lafata et al 2008;Gleason et al 2009;Karaca-Mandic et al 2010;Kim et al 2011;Palmer et al 2012;Romley et al 2012;Desai et al 2014;Starner et al 2014). Thus, future examinations of specialty tier-level cost sharing among new users of MS and RA specialty drugs might be expected to show even greater effects.…”

“…Outcomes were measured in both the preperiod (lower cost sharing) and postperiod (higher cost sharing). In keeping with prior studies, the primary study outcome was presence or absence of a gap in specialty drug treatment (Curkendall et al 2008;Lafata et al 2008;Borah et al 2009;Yazici et al 2009;Reynolds et al 2010;Kim et al 2011;Evans et al 2012). This was captured via a dichotomous measure of whether a patient's claims data indicated at least one continuous gap of ≥30 days with no supply of a disease-specific Part D specialty drug (Sikka, Xia, and Aubert 2005;Peterson et al 2007).…”

Cost-Control Mechanisms in Canadian Private Drug Plans

“…Specialty drugs are becoming increasingly popular, including some that can cost hundreds of thousands of dollars every year (Goldman 2006;Kim et al 2011). If this trend continues, it is likely that many Canadians, including those with chronic conditions, will hit these benefits limits.…”

Impact of a transition to more restrictive drug formulary on therapy discontinuation and medication adherence

“…However, prior efforts to implement restrictive formularies have been associated with inconsistent rates of therapy discontinuation and mixed impacts on adherence to therapy. Some have shown no impact on adherence and therapy discontinuation, whereas others have shown otherwise . Little is known about therapy disruption rates among patients transferring from already restrictive formulary to a more restrictive model and medication adherence among patients initiating therapy in such a restrictive environment.…”