The Impact of Cost Sharing on Antidepressant Use Among Older Adults in British Columbia

Abstract

Objective-Antidepressant therapies are underused among older adults and could be further curtailed by patient cost-sharing requirements. The authors studied the effects of two sequential costsharing policies in a large, stable population of all British Columbia seniors: change from full prescription coverage to $10-$25 copayments (copay) in January 2002 and replacement with incomebased deductibles and 25% coinsurance in May 2003.Methods-PharmaNet data were used to calculate monthly dispensing of antidepressants (in imipramine-equivalent milligrams) among all British Columbia residents age 65 and older beginning January 1997 through December 2005. Monthly rates of starting and stopping antidepressants were calculated. Population-level patterns over time were plotted, and the effects of implementing costsharing policies on antidepressant use, initiation, and stopping were examined in segmented linear regression models.Results-Implementation of the copay policy was not associated with significant changes in level of antidepressant dispensing or the rate of dispensing growth. Subsequent implementation of the income-based deductible policy also did not lead to a significant change in dispensing level but led to a significant (p=.02) decrease in the rate of growth of antidepressant dispensing. The copay policy was associated with a significant (p=.01) drop in the frequency of antidepressant initiation among persons with depression. Income-based deductibles reduced the rate of increase in antidepressant This research was presented in a poster session at the 22nd

Impact of generic competition on market share and prices of cardiovascular medicines on the Bulgarian pharmaceutical market

“…Grootendorst (2001) analysed the impact of referenced -based pricing on nitrates usage and cost reduction by using also the cost per milligram. Similar approach was found useful in case of comparison of the medicines prices for particular therapeutic groups (Wang 2008) , which is also the case in our study. …”

Impact of generic competition on market share and prices of cardiovascular medicines on the Bulgarian pharmaceutical market

“…Grootendorst (2001) analysed the impact of referenced -based pricing on nitrates usage and cost reduction by using also the cost per milligram. Similar approach was found useful in case of comparison of the medicines prices for particular therapeutic groups (Wang 2008) , which is also the case in our study. …”

Impact of Medicare Part D on Medicare–Medicaid Dual‐Eligible Beneficiaries' Prescription Utilization and Expenditures

“…8. Evidence of such anticipatory prescribing behavior or ''stockpiling'' can be found in the literature (Marshall et al 2002;Wang et al 2008).…”

Costs and Benefits of Free Medications after Myocardial Infarction

“…finally, we discuss an intervention that is feasible and represents an innovative approach to improving health outcomes. Several studies have examined the impact of cost-sharing on prescription drug adherence within government-funded pharmaceutical programs in Canada (Tamblyn et al 2001;Li et al 2007;Anis et al 2005;Wang et al 2008;Schneeweiss et al 2007a,b), and at least one study has examined the impact of cost-sharing for patients who have private drug insurance (ungar et al 2008). Even with relatively small copayments, all these studies have found that cost-sharing significantly reduces adherence even after myocardial infarction (Schneeweiss et al 2007a,b).…”

Impact of generic competition on market share and prices of cardiovascular medicines on the Bulgarian pharmaceutical market

“…Grootendorst (2001) analysed the impact of referenced -based pricing on nitrates usage and cost reduction by using also the cost per milligram. Similar approach was found useful in case of comparison of the medicines prices for particular therapeutic groups (Wang 2008) , which is also the case in our study. …”

Impact of Medicare Part D on Medicare–Medicaid Dual‐Eligible Beneficiaries' Prescription Utilization and Expenditures

“…8. Evidence of such anticipatory prescribing behavior or ''stockpiling'' can be found in the literature (Marshall et al 2002;Wang et al 2008).…”

Costs and Benefits of Free Medications after Myocardial Infarction

“…finally, we discuss an intervention that is feasible and represents an innovative approach to improving health outcomes. Several studies have examined the impact of cost-sharing on prescription drug adherence within government-funded pharmaceutical programs in Canada (Tamblyn et al 2001;Li et al 2007;Anis et al 2005;Wang et al 2008;Schneeweiss et al 2007a,b), and at least one study has examined the impact of cost-sharing for patients who have private drug insurance (ungar et al 2008). Even with relatively small copayments, all these studies have found that cost-sharing significantly reduces adherence even after myocardial infarction (Schneeweiss et al 2007a,b).…”

Impact of generic competition on market share and prices of cardiovascular medicines on the Bulgarian pharmaceutical market

“…Grootendorst (2001) analysed the impact of referenced -based pricing on nitrates usage and cost reduction by using also the cost per milligram. Similar approach was found useful in case of comparison of the medicines prices for particular therapeutic groups (Wang 2008) , which is also the case in our study. …”

Impact of Medicare Part D on Medicare–Medicaid Dual‐Eligible Beneficiaries' Prescription Utilization and Expenditures

“…8. Evidence of such anticipatory prescribing behavior or ''stockpiling'' can be found in the literature (Marshall et al 2002;Wang et al 2008).…”

Costs and Benefits of Free Medications after Myocardial Infarction

“…finally, we discuss an intervention that is feasible and represents an innovative approach to improving health outcomes. Several studies have examined the impact of cost-sharing on prescription drug adherence within government-funded pharmaceutical programs in Canada (Tamblyn et al 2001;Li et al 2007;Anis et al 2005;Wang et al 2008;Schneeweiss et al 2007a,b), and at least one study has examined the impact of cost-sharing for patients who have private drug insurance (ungar et al 2008). Even with relatively small copayments, all these studies have found that cost-sharing significantly reduces adherence even after myocardial infarction (Schneeweiss et al 2007a,b).…”