Powered by: Blackwell Publishing

HRET - Health Research & Educational Trust

HSR - Health Services Research

Impacting Health Practice and Policy Through State-of-the-Art Research and Thinking

Our Next Issue

December 2018
Coming Soon! Read

< ABSTRACT LIST

VOLUME 45 | NUMBER 5 | OCTOBER 2010


Cost Sharing, Family Health Care Burden, and the Use of Specialty Drugs for Rheumatoid Arthritis

Keywords:
Specialty drugs;pharmacy benefit design;household burden
Objectives. To examine the impact of benefit generosity and household health care financial burden on the demand for specialty drugs in the treatment of rheumatoid arthritis (RA).

Data Sources/Study Setting. Enrollment, claims, and benefit design information for 35 large private employers during 2000–2005.

Study Design. We estimated multivariate models of the effects of benefit generosity and household financial burden on initiation and continuation of biologic therapies.

Data Extraction Methods. We defined initiation of biologic therapy as first-time use of etanercept, adalimumab, or infliximab, and we constructed an index of plan generosity based on coverage of biologic therapies in each plan. We estimated the household's burden by summing up the annual out-of-pocket (OOP) expenses of other family members.

Principal Findings. Benefit generosity affected both the likelihood of initiating a biologic and continuing drug therapy, although the effects were stronger for initiation. Initiation of a biologic was lower in households where other family members incurred high OOP expenses.

Conclusions. The use of biologic therapy for RA is sensitive to benefit generosity and household financial burden. The increasing use of coinsurance rates for specialty drugs (as under Medicare Part D) raises concern about adverse health consequences.

back to top | back to article index | access/purchase full article

Copyright© 2018, Health Research & Educational Trust. All rights reserved. Content Disclaimer
Health Research & Educational Trust, 155 North Wacker, 4th Floor Chicago, IL 60606 (312) 422.2600