A comparison between the effects of drug costs and share of family income on drug costs in determining drug price.
Cost of Illness
Costs and Cost Analysis
Drug Costs
/ standards
Family Characteristics
Female
Financial Stress
Health Expenditures
Health Services Accessibility
/ standards
Health Services Needs and Demand
Humans
Income
/ statistics & numerical data
Male
Middle Aged
Prescription Drugs
/ economics
United States
/ epidemiology
Journal
Medicine
ISSN: 1536-5964
Titre abrégé: Medicine (Baltimore)
Pays: United States
ID NLM: 2985248R
Informations de publication
Date de publication:
06 Aug 2021
06 Aug 2021
Historique:
received:
28
10
2020
accepted:
22
07
2021
entrez:
16
8
2021
pubmed:
17
8
2021
medline:
3
9
2021
Statut:
ppublish
Résumé
High health care and medication expenditures pose a financial burden on Americans seeking care. It is imperative to determine the role of affordability in influencing access to health care and medications.To investigate the association between financial burden and health care access by comparing the effects of absolute and relative financial burdens, measured by total health care/medication expenditure (Expenditure) and health care/medication expenditure as a share of annual family income (Expenditure Share), respectively.Delay in receiving health care services and delay in obtaining prescription medications.A cross-sectional analysis of the 2017 Medical Expenditure Panel Survey using multivariate logistic regressions with Expenditure and Expenditure Share variables standardized to facilitate comparison.While both absolute and relative financial burdens were found to be positively associated with the outcomes, the relative measure had a significantly higher association that was about twice as much as the absolute one. For the outcome of delay in getting health care, the standardized odds ratios (OR) for health care expenditure and health care expenditure as a share of family income were 1.13 (95% confidence interval [CI] = 1.09-1.18) and 1.25 (95% CI = 1.20-1.32), respectively. For the outcome of delay in getting medications, the standardized OR for medication expenditure and medication expenditure as a share of family income were 1.11 (95% CI = 1.08-1.15) and 1.23 (95% CI = 1.18-1.29), respectively.The study illustrated the importance of including income in policy considerations intended to balance value, access, and affordability. Specifically, income should be included in measures assessing the value of medications.
Identifiants
pubmed: 34397865
doi: 10.1097/MD.0000000000026877
pii: 00005792-202108060-00078
pmc: PMC8341252
doi:
Substances chimiques
Prescription Drugs
0
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
e26877Subventions
Organisme : NIA NIH HHS
ID : R01 AG049696
Pays : United States
Organisme : NIA NIH HHS
ID : R01AG049696
Pays : United States
Informations de copyright
Copyright © 2021 the Author(s). Published by Wolters Kluwer Health, Inc.
Déclaration de conflit d'intérêts
The authors have no conflicts of interests to disclose.
Références
Collins SR, Rasmussen PW, Doty MM, et al. Too high a price: Out-of-pocket health care costs in the United States. Findings from the Commonwealth Fund Health Care Affordability Tracking Survey, September-October 2014. Issue Brief (Commonwealth Fund) 2014;29:01–11. Available at: https://www.commonwealthfund.org/sites/default/files/documents/___media_files_publications_issue_brief_2014_nov_1784_collins_too_high_a_price_out_of_pocket_tb_v2.pdf . Accessed October 1, 2020.
Papanicolas I, Woskie LR, Jha AK. Health care spending in the United States and other high-income countries. JAMA 2018;319:1024–39.
Briesacher BA, Ross-Degnan D, Wagner AK, et al. Out-of-pocket burden of health care spending and the adequacy of the Medicare Part D low-income subsidy. Med Care 2010;48:503–9.
Kesselheim AS, Avorn J, Sarpatwari A. The high cost of prescription drugs in the United States: origins and prospects for reform. JAMA 2016;316:858–71.
Morgan SG, Good CB, Leopold C, et al. An analysis of expenditures on primary care prescription drugs in the United States versus ten comparable countries. Health Policy 2018;122:1012–7.
Blumberg LJ, Waidmann TA, Blavin F, et al. Trends in health care financial burdens, 2001 to 2009. Milbank Q 2014;92:88–113.
Choi C, Shaikh NF, John J, et al. By the numbers: Balancing affordability, value, and access. Value Outcomes Spotlight 2019;5:22.
Galbraith AA, Ross-Degnan D, Soumerai SB, et al. Nearly half of families in high-deductible health plans whose members have chronic conditions face substantial financial burden. Health Aff 2011;30:322–31.
Huskamp HA, Deverka PA, Epstein AM, et al. Impact of 3-tier formularies on drug treatment of attention-deficit/hyperactivity disorder in children. Arch Gen Psychiatry 2005;62:435–41.
U.S. Department of Health and Human Services. Healthy People 2030: Health care access and quality. 2020. Available at: https://health.gov/healthypeople/objectives-and-data/browse-objectives/health-care-access-and-quality . Accessed September 20, 2020.
Wyszewianski L. Families with catastrophic health care expenditures. Health Serv Res 1986;21:617–34.
Wisk LE, Witt WP. Predictors of delayed or forgone needed health care for families with children. Pediatrics 2012;130:1027–37.
Pearson SD, Ollendorf DA, Chapman RH. New cost-effectiveness methods to determine value-based prices for potential cures: what are the options? Value Health 2019;22:656–60.
U.S. Department of Health and Human Services. Medical Expenditure Panel Survey background. 2020. Available at: https://www.meps.ahrq.gov/mepsweb/about_meps/survey_back.jsp . Accessed July 22, 2020.
Agency for Healthcare Research and Quality. MEPS Access to Care Section. 2005. Available at: https://meps.ahrq.gov/survey_comp/hc_survey/2005/AC95.htm . Accessed August 6, 2020.
Gelberg L, Andersen RM, Leake BD. The behavioral model for vulnerable populations: application to medical care use and outcomes for homeless people. Health Serv Res 2000;34:1273–302.
SAS [computer program]. Version 9.4. Cary, NC: SAS Institute Inc; 2014.
Chen H, Cohen P, Chen S. How big is a big odds ratio? Interpreting the magnitudes of odds ratios in epidemiological studies. Commun Stat Simul Caomput 2010;39:860–4.
Institute for Clinical and Economic Review. Cost-effectiveness, the QALY, and the evLYG. 2020. Available at: https://icer-review.org/methodology/qaly/ . Accessed September 20, 2020.
Cleary M. The balance between affordability, value and access. Value Outcomes Spotlight 2019;5:18–21.
Godman B, Bucsics A, Bonanno PV, et al. Barriers for access to new medicines: searching for the balance between rising costs and limited budgets. Front Public Health 2018;6:328doi:10.3389/fpubh.2018.00328.
doi: 10.3389/fpubh.2018.00328
Value & Outcomes Spotlight. Moving from volume to value: Humana's approach to addressing the affordability challenge. Value Outcomes Spotlight 2019;5:33–5.