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Research Studies is a compilation of published research articles funded by AHRQ or authored by AHRQ researchers.
Results
1 to 5 of 5 Research Studies DisplayedAnderson KE, DiStefano MJ, Liu A
Incorporating added therapeutic benefit and domestic reference pricing into Medicare payment for expensive part B drugs.
The objective of this retrospective analysis was to identify expensive Part B drugs and to consider the evidence for each drug's added benefit in order to model a reimbursement policy for Medicare that integrates added benefit assessment and domestic reference pricing. Data were taken from a nationally representative sample of traditional Medicare Part B claims. The analysis showed that more than one-third of the expensive Part B drugs prescribed in 2019 offered low added benefit. The authors concluded that reference pricing based on added benefit assessment could be used to address the launch prices for expensive Part B drugs with low added benefit.
AHRQ-funded; HS000029.
Citation: Anderson KE, DiStefano MJ, Liu A .
Incorporating added therapeutic benefit and domestic reference pricing into Medicare payment for expensive part B drugs.
Value Health 2023 Sep; 26(9):1381-88. doi: 10.1016/j.jval.2023.05.018..
Keywords: Medicare, Payment, Medication, Healthcare Costs
Alpert A, Lakdawalla D, Sood N
Prescription drug advertising and drug utilization: the role of Medicare Part D.
The purpose of this paper was to explore how direct-to-consumer advertising (DTCA) for prescription drugs affects use by leveraging a large and plausibly exogenous shock to DTCA influenced by the introduction of Medicare Part D. Part D led to greater increases in advertising in geographic areas with greater concentrations of Medicare beneficiaries. The researchers explored the effect of this increase in advertising on non-elderly individuals to separate the effects of advertising from the direct effects of Part D. The study found that exposure to advertising resulted in large increases in treatment initiation and improved adherence to medication. Advertising also had substantial positive spillover effects on non-advertised generic drugs.
AHRQ-funded; HS025983.
Citation: Alpert A, Lakdawalla D, Sood N .
Prescription drug advertising and drug utilization: the role of Medicare Part D.
J Public Econ 2023 May; 221. doi: 10.1016/j.jpubeco.2023.104860..
Keywords: Communication, Medication, Medicare
Bond AM, Dean EB, Desai SM
The role of financial incentives in biosimilar uptake in Medicare: Evidence from the 340b program.
This study’s goal was to investigate whether the 340B Drug Pricing Program, which offers eligible hospitals substantial discounts on drug purchases, inhibits biosimilar uptake. Almost one-third of eligible US hospitals participate in the program. The authors used regression discontinuity design and two high-volume biologics with biosimilar competitors, filgrastim and infliximab to estimate that 340B program eligibility was associated with a 22.9-percentage-point reduction in biosimilar adoption. Additionally, 340B program eligibility was associated with 13.3 more biologic administrations annually per hospital and $17,919 more biologic revenue per hospital. The effect was found to be that it inhibited biosimilar uptake, possibly because of financial incentives that make reference drugs more profitable than biosimilar medications.
AHRQ-funded; HS027531.
Citation: Bond AM, Dean EB, Desai SM .
The role of financial incentives in biosimilar uptake in Medicare: Evidence from the 340b program.
Health Aff 2023 May; 42(5):632-41. doi: 10.1377/hlthaff.2022.00812..
Keywords: Medicare, Medication, Healthcare Costs
Levin JS, Komanduri S, Whaley C
Association between hospital-physician vertical integration and medication adherence rates.
This study’s goal was to test the association between vertical integration of primary care providers (PCPs) and adherence rates for anti-diabetics, renin angiotensin system antagonists (RASA), and statins. Data was extracted from Medicare Part B outpatient fee-for-service claims and Medicare Part D event data from 2014 to 2017. There was a 23% increase in the proportion of patients who had a vertically integrated PCP during the study period. Changes in adherence did not differ significantly between patients based on whether their PCP became integrated. However, among patients with PCPs who become integrated, there were significant decreases in patients who were above 80 years old, were Black, Asian, Hispanic, or Native America, and had greater comorbidities for all three classes.
AHRQ-funded; HS024067.
Citation: Levin JS, Komanduri S, Whaley C .
Association between hospital-physician vertical integration and medication adherence rates.
Health Serv Res 2023 Apr; 58(2):356-64. doi: 10.1111/1475-6773.14090.
Keywords: Medication, Patient Adherence/Compliance, Medicare, Primary Care
Growdon ME, Gan S, Yaffe K
New psychotropic medication use among Medicare beneficiaries with dementia after hospital discharge.
Hospital stays often trigger behavioral shifts in people with dementia (PWD), potentially leading to the prescription of psychotropic drugs despite their limited effectiveness and potential for harmful side-effects. The purpose of this study was to ascertain the prevalence of new psychotropic drug prescriptions in PWD living in the community after their discharge from the hospital, and within these new users, the percentage who continued their use for an extended duration. The researchers conducted a retrospective cohort study, utilizing a random selection of Medicare claims from 2017. The study included PWD hospital patients who were 68 years or older and covered by traditional and Part D Medicare. The primary outcome was the event of prescribing at the time of discharge psychotropic drugs including antipsychotics, sedative-hypnotics, antiepileptics, and antidepressants. The initiation was characterized as new prescriptions (from classes not utilized in the 180 days preceding admission) filled within a week of discharge from the hospital or skilled nursing facility. Extended use was defined as the percentage of new users who continued to refill the newly prescribed medications for more than 90 days post-discharge. The study population consisted of 117,022 hospitalized PWD with an average age of 81 years, with 63% being female. The study found that prior to admission, 63% were already using at least one psychotropic drug; 10% were using drugs from three or more psychotropic classes. These classes included antidepressants (44% pre-admission), antiepileptics (29%), sedative-hypnotics (21%), and antipsychotics (11%). The percentage of PWD discharged with new psychotropic prescriptions ranged from 1.9% (antipsychotics) to 2.9% (antiepileptics); 6.6% had at least one new class initiated. Among these new users, prolonged use varied from 36% (sedative-hypnotics) to 63% (antidepressants); across drug classes, prolonged use was observed in 51%. Factors associated with the initiation of new psychotropics included duration of hospital stay and delirium.
AHRQ-funded; HS026383.
Citation: Growdon ME, Gan S, Yaffe K .
New psychotropic medication use among Medicare beneficiaries with dementia after hospital discharge.
J Am Geriatr Soc 2023 Apr; 71(4):1134-44. doi: 10.1111/jgs.18161..
Keywords: Elderly, Medication, Medicare, Dementia, Neurological Disorders, Hospitalization