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Research Studies is a compilation of published research articles funded by AHRQ or authored by AHRQ researchers.
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1 to 1 of 1 Research Studies DisplayedDing Y, Miller GE
AHRQ Author: Ding Y, Miller GE
The impact of sharing drug rebates at the point of sale on out-of-pocket payments for enrollees in employer-sponsored insurance.
The purpose of this study was to estimate the effect of sharing drug rebates at the point of sale on out-of-pocket spending by connecting estimated rebates to administrative claims data for employer-sponsored insurance enrollees in 2018. The researchers utilized the drug rebate rate with the retail price of each brand name drug fill, and the reductions were allocated to out-of-pocket spending based on cost-sharing provisions. Individual out-of-pocket spending was aggregated across drug fills. It was assumed that generic drugs have no rebates for employer-sponsored insurance. The impact of sharing rebates at the point of sale on out-of-pocket spending overall, for therapeutic classes and specific drugs with the highest average out-of-pocket spending per user, and by health plan type was assessed. The study found that across four simulations with different assumptions about cross-fill effects, 10.4% to 12.2% of enrollees in the sample would have realized savings on out-of-pocket spending if rebates were shared at the point of sale. Among those with savings, approximately half would save $50 or less, and 10% would save more than $500 annually. A premium increase of $1.06 to $1.41 per member per month among the continuously enrolled, insured population would be sufficient to finance the out-of-pocket savings in the sample.
AHRQ-authored.
Citation: Ding Y, Miller GE .
The impact of sharing drug rebates at the point of sale on out-of-pocket payments for enrollees in employer-sponsored insurance.
Value Health 2023 Feb; 26(2):226-33. doi: 10.1016/j.jval.2022.08.001..
Keywords: Health Insurance, Medication