National Healthcare Quality and Disparities Report
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AHRQ Research Studies Date
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- Access to Care (1)
- Adverse Drug Events (ADE) (1)
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- Asthma (1)
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AHRQ Research Studies
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Research Studies is a compilation of published research articles funded by AHRQ or authored by AHRQ researchers.
Results
1 to 25 of 28 Research Studies DisplayedSlota C, Davis SA, Blalock SJ
Patient-physician communication on medication cost during glaucoma visits.
The aim of this secondary analysis was to describe the frequency and nature of patient-physician communication regarding medication cost during glaucoma office visits. Most participants did not discuss medication cost during their glaucoma office visit. The majority of the subjects who discussed cost had mild disease severity (51 percent), took one glaucoma medication (63 percent), and had Medicare (49 percent) as well as a form of prescription insurance (78 percent).
AHRQ-funded; HS023054.
Citation: Slota C, Davis SA, Blalock SJ .
Patient-physician communication on medication cost during glaucoma visits.
Optom Vis Sci 2017 Dec;94(12):1095-101. doi: 10.1097/opx.0000000000001139.
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Keywords: Eye Disease and Health, Healthcare Costs, Medication, Patient and Family Engagement, Clinician-Patient Communication
Kazi DS, Lu CY, Lin GA
Nationwide coverage and cost-sharing for PCSK9 inhibitors among Medicare Part D plans.
In this research letter the investigators analyzed the June 2016 Centers for Medicare and Medicaid Services Prescription Drug Plan Formulary, Pharmacy Network, and Pricing Information Files for all Part D plans (except special-needs plans that may have had specialized formularies) and out-of-pocket cost requirements for PCSK9is (alirocumab and evolocumab) averaged across all plans by counties and states. The authors asserted that their findings suggest a need to lower out-of pocket costs to ensure affordability of PCSK9is for Medicare beneficiaries covered by Part D.
AHRQ-funded; HS016772.
Citation: Kazi DS, Lu CY, Lin GA .
Nationwide coverage and cost-sharing for PCSK9 inhibitors among Medicare Part D plans.
JAMA Cardiol 2017 Oct;2(10):1164-66. doi: 10.1001/jamacardio.2017.3051..
Keywords: Healthcare Costs, Medicare, Medication, Policy
Zhang M, Silverberg JI, Kaffenberger BH
Prescription patterns and costs of acne/rosacea medications in Medicare patients vary by prescriber specialty.
The researchers described the medications used for treating acne/rosacea in the Medicare population and evaluated differences in costs between specialties. They concluded that costs of prescriptions for acne/rosacea from specialists are higher than those from primary care physicians and could be reduced by choosing generic and less expensive options.
AHRQ-funded; HS023011.
Citation: Zhang M, Silverberg JI, Kaffenberger BH .
Prescription patterns and costs of acne/rosacea medications in Medicare patients vary by prescriber specialty.
J Am Acad Dermatol 2017 Sep;77(3):448-55.e2. doi: 10.1016/j.jaad.2017.04.1127.
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Keywords: Medication, Skin Conditions, Healthcare Costs, Medicare, Elderly
Robinson JC, Whaley CM, Brown TT
Association of reference pricing with drug selection and spending.
This study used difference-in-differences multivariable regression methods to analyze changes in prescriptions and pricing for 1,302 drugs in 78 therapeutic classes in the United States, before and after implementation of reference pricing by an alliance of private employers. It concluded that mplementation of reference pricing was associated with a higher rate of copayment by patients than in the comparison group.
AHRQ-funded; HS22098.
Citation: Robinson JC, Whaley CM, Brown TT .
Association of reference pricing with drug selection and spending.
N Engl J Med 2017 Aug 17;377(7):658-65. doi: 10.1056/NEJMsa1700087.
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Keywords: Healthcare Costs, Medication
Chen Y, Lairson DR, Chan W
Cost-effectiveness of novel agents in medicare patients with multiple myeloma: findings from a U.S. payer's perspective.
The researchers sought to determine the cost-effectiveness (measured as cost per life-year saved) of front-line novel agent-based therapy use among a cohort of elderly patients with multiple myeloma (MM) in a real-world setting. They concluded that, given the most common treatment practices in the United States, the use of novel agent-based therapy is not cost-effective at its current level of cost and effectiveness.
AHRQ-funded; HS018956.
Citation: Chen Y, Lairson DR, Chan W .
Cost-effectiveness of novel agents in medicare patients with multiple myeloma: findings from a U.S. payer's perspective.
J Manag Care Spec Pharm 2017 Aug;23(8):831-43. doi: 10.18553/jmcp.2017.23.8.831.
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Keywords: Healthcare Costs, Cancer, Comparative Effectiveness, Healthcare Costs, Medication
Shih YT, Xu Y, Liu L
Rising prices of targeted oral anticancer medications and associated financial burden on Medicare beneficiaries.
This study examined trends in targeted oral anticancer medication (TOAM) prices and patient out-of-pocket (OOP) payments in Medicare Part D and estimated the actual effects on patient OOP payments of partial filling of the coverage gap by 2012. It concluded that rising TOAM prices threaten the financial relief patients have begun to experience under closure of the coverage gap in Medicare Part D.
AHRQ-funded; HS020263.
Citation: Shih YT, Xu Y, Liu L .
Rising prices of targeted oral anticancer medications and associated financial burden on Medicare beneficiaries.
J Clin Oncol 2017 Aug 1;35(22):2482-89. doi: 10.1200/jco.2017.72.3742.
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Keywords: Cancer, Medication, Healthcare Costs, Medicare, Elderly
Tajeu GS, Mennemeyer S, Menachemi N
Cost-effectiveness of antihypertensive medication: exploring race and sex differences using data from the REasons for Geographic and Racial Differences in Stroke Study.
The researchers compared the cost-effectiveness of antihypertensive medication treatment versus no-treatment in white and black adults. They concluded that antihypertensive medication treatment is cost-saving and increases quality-adjusted life-years (QALYs) for all groups considered in the model, particularly among black adults.
AHRQ-funded; HS013852.
Citation: Tajeu GS, Mennemeyer S, Menachemi N .
Cost-effectiveness of antihypertensive medication: exploring race and sex differences using data from the REasons for Geographic and Racial Differences in Stroke Study.
Med Care 2017 Jun;55(6):552-60. doi: 10.1097/mlr.0000000000000719.
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Keywords: Medication, Blood Pressure, Healthcare Costs, Racial and Ethnic Minorities, Stroke
Haidari LA, Brown ST, Wedlock P
When are solar refrigerators less costly than on-grid refrigerators: a simulation modeling study.
Gavi the Vaccine Alliance recommends solar refrigerators for vaccine storage in areas with less than eight hours of electricity per day, and World Health Organization guidelines are more conservative. This study investigated whether solar refrigerators provide value where electrical outages are less frequent. It identified the frequency and duration at which electrical outages need to occur for solar refrigerators to provide savings in total cost per dose administered over electric refrigerators at different solar refrigerator prices.
AHRQ-funded; HS023317.
Citation: Haidari LA, Brown ST, Wedlock P .
When are solar refrigerators less costly than on-grid refrigerators: a simulation modeling study.
Vaccine 2017 Apr 19;35(17):2224-28. doi: 10.1016/j.vaccine.2016.11.103.
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Keywords: Healthcare Costs, Medication, Vaccination
Berger BA, Cossio A, Saravia NG
Cost-effectiveness of meglumine antimoniate versus miltefosine caregiver DOT for the treatment of pediatric cutaneous leishmaniasis.
The researchers performed a cost-effectiveness analysis comparing Miltefosine administered via in-home caregiver Directly Observed Therapy (cDOT) versus injectable meglumine antimoniate (MA) for pediatric cutaneous leishmaniasis (CL) in southwest Colombia. Treatment of pediatric CL miltefosine via cDOT was found to be cost saving from patient and societal perspectives, and moderately more costly from the government payer perspective compared to treatment with MA.
AHRQ-funded; HS022433.
Citation: Berger BA, Cossio A, Saravia NG .
Cost-effectiveness of meglumine antimoniate versus miltefosine caregiver DOT for the treatment of pediatric cutaneous leishmaniasis.
PLoS Negl Trop Dis 2017 Apr 6;11(4):e0005459. doi: 10.1371/journal.pntd.0005459.
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Keywords: Patient-Centered Outcomes Research, Healthcare Costs, Medication, Healthcare Costs, Children/Adolescents
Zullo AR, Howe CJ, Galarraga O
Estimating the effect of health insurance on personal prescription drug importation.
Personal prescription drug importation occurs in the United States because of the high cost of U.S. medicines and lower cost of foreign equivalents. The investigators used inverse probability weighted marginal structural models and data on 87,494 individuals from the 2011-2013 National Health Interview Survey to estimate the marginal association between no health insurance and importation within U.S. subpopulations.
AHRQ-funded; HS022998.
Citation: Zullo AR, Howe CJ, Galarraga O .
Estimating the effect of health insurance on personal prescription drug importation.
Med Care Res Rev 2017 Apr;74(2):178-207. doi: 10.1177/1077558716629039..
Keywords: Health Insurance, Healthcare Costs, Medication
Yeung K, Basu A, Marcum ZA
Impact of a value-based formulary in three chronic disease cohorts.
This study assessed the impact of a value based formulary (VBF) on medication adherence and patient and health plan expenditures on 3 chronic disease states: diabetes, hypertension, and hyperlipidemia. The investigators measured medication expenditures from member, health plan, and member-plus-health plan (overall) perspectives and medication adherence as proportion of days covered. They conducted an exploratory analysis of medication utilization classifying medications according to whether co-payments moved up or down in the year following VBF implementation.
AHRQ-funded; HS022982.
Citation: Yeung K, Basu A, Marcum ZA .
Impact of a value-based formulary in three chronic disease cohorts.
Am J Manag Care 2017 Mar; 23(3 Suppl):S46-s53..
Keywords: Chronic Conditions, Health Insurance, Patient Adherence/Compliance, Medication, Healthcare Costs
Shen C, Zhao B, Liu L
Financial burden for patients with chronic myeloid leukemia enrolled in Medicare Part D taking targeted oral anticancer medications.
In this study, the investigators examined financial burden for patients with chronic myeloid leukemia enrolled in Medicare Part D taking targeted oral anticancer medications. The authors concluded that patients experience quick entry and exit from the coverage gap (also called the donut hole) as a result of the high price of targeted oral anticancer medications. They suggested that closing the donut hole would provide financial relief during the initial month(s) of treatment but will not completely eliminate the financial burden.
AHRQ-funded; HS020263.
Citation: Shen C, Zhao B, Liu L .
Financial burden for patients with chronic myeloid leukemia enrolled in Medicare Part D taking targeted oral anticancer medications.
J Oncol Pract 2017 Feb;13(2):e152-e62. doi: 10.1200/JOP.2016.014639..
Keywords: Cancer, Chronic Conditions, Elderly, Healthcare Costs, Medicare, Medication
Yeung K, Basu A, Hansen RN
Impact of a value-based formulary on medication utilization, health services utilization, and expenditures.
The objective of the study was to determine the impact of the value-based formulary (VBF). It found that cost-sharing informed by cost-effectiveness analysis reduced overall medication expenditures without negatively impacting medication utilization, health services utilization, or nonmedication expenditures.
AHRQ-funded; HS023346.
Citation: Yeung K, Basu A, Hansen RN .
Impact of a value-based formulary on medication utilization, health services utilization, and expenditures.
Med Care 2017 Feb;55(2):191-98. doi: 10.1097/mlr.0000000000000630.
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Keywords: Medication, Healthcare Utilization, Healthcare Costs, Health Services Research (HSR)
Vaughan Sarrazin MS, Jones M, Mazur A
Cost of hospital admissions in Medicare patients with atrial fibrillation taking warfarin, dabigatran, or rivaroxaban.
The purpose of this study was to examine the impact of anticoagulant choice on inpatient costs in patients with nonvalvular atrial fibrillation (AF). Analysis used 3-way propensity matching to create groups from AF patients taking dabigatran, rivaroxaban, or warfarin, and were plausible candidates for all 3 anticoagulants. Predicted values from two models were multiplied together to estimate expected costs per patient-year. The study concludes from its data that patients with newly diagnosed AF taking 150 mg dabigatran or 20 mg rivaroxaban experience lower annual inpatient costs than patients taking warfarin, due to fewer hospital admissions for stroke, non-gastrointestinal-related hemorrhages, and heart failure events.
AHRQ-funded; HS023104.
Citation: Vaughan Sarrazin MS, Jones M, Mazur A .
Cost of hospital admissions in Medicare patients with atrial fibrillation taking warfarin, dabigatran, or rivaroxaban.
J Am Coll Cardiol 2017 Jan 24;69(3):360-62. doi: 10.1016/j.jacc.2016.11.023..
Keywords: Blood Thinners, Heart Disease and Health, Medication, Healthcare Costs, Medicare, Hospitalization, Cardiovascular Conditions
Friesen KJ, Chateau D, Falk J
Cost of shingles: population based burden of disease analysis of herpes zoster and postherpetic neuralgia.
In order to determine the healthcare system burden of herpes zoster (HZ) using direct medical costs, researchers analyzed administrative healthcare data collected from 1997 to 2014. They found a large increase in incidence of HZ, with rising per episode medical and prescription costs but this was offset by dramatic drops in hospitalization rates, the net effect of which has been to hold the total costs relatively constant.
AHRQ-funded; HS017918.
Citation: Friesen KJ, Chateau D, Falk J .
Cost of shingles: population based burden of disease analysis of herpes zoster and postherpetic neuralgia.
BMC Infect Dis 2017 Jan 13;17(1):69. doi: 10.1186/s12879-017-2185-3.
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Keywords: Healthcare Costs, Medication, Hospitalization
Michaelidis CI, Fine MJ, Lin CJ
The hidden societal cost of antibiotic resistance per antibiotic prescribed in the United States: an exploratory analysis.
This study estimated the hidden societal cost of antibiotic resistance per antibiotic prescribed in the United States. It concluded that each ambulatory antibiotic prescription is associated with a hidden societal cost of antibiotic resistance (SCAR) that substantially increases the cost of an antibiotic prescription in the United States. This finding raises concerns regarding the magnitude of misalignment between individual and societal antibiotic costs.
AHRQ-funded; HS024930.
Citation: Michaelidis CI, Fine MJ, Lin CJ .
The hidden societal cost of antibiotic resistance per antibiotic prescribed in the United States: an exploratory analysis.
BMC Infect Dis 2016 Nov 8;16(1):655. doi: 10.1186/s12879-016-1990-4.
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Keywords: Medication, Primary Care, Hospitalization, Healthcare Costs, Ambulatory Care and Surgery
Beckman AL, Bilinski A, Boyko R
New hepatitis C drugs are very costly and unavailable to many state prisoners.
This study found that in the forty-one states whose departments of corrections reported data, 106,266 inmates (10 percent of their prisoners) were known to have hepatitis C on or about January 1, 2015. Only 949 of those inmates were being treated. Prices for a twelve-week course of direct-acting antivirals such as sofosbuvir and the combination drug ledipasvir/sofosbuvir varied widely as of September 30, 2015 ($43,418-$84,000 and $44,421-$94,500, respectively).
AHRQ-funded; HS000055.
Citation: Beckman AL, Bilinski A, Boyko R .
New hepatitis C drugs are very costly and unavailable to many state prisoners.
Health Aff 2016 Oct;35(10):1893-901. doi: 10.1377/hlthaff.2016.0296.
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Keywords: Access to Care, Healthcare Costs, Hepatitis, Medication, Vulnerable Populations
Eaton EF, Tamhane A, Saag M
Cost considerations in the current antiretroviral era.
The authors analyzed the relative cost-effectiveness of contemporary antiretroviral therapy in real-world clinical settings. They found that, among the participants studied, raltegravir and efavirenz-based regimens were the most cost-effective options for treatment-naive patients. They suggested that these findings are relevant given changes in recommended regimens for treatment-naive persons. The authors recommended that further data on the comparative effectiveness of efavirenz and rilpivirine are needed.
AHRQ-funded; HS013852.
Citation: Eaton EF, Tamhane A, Saag M .
Cost considerations in the current antiretroviral era.
AIDS 2016 Sep 10;30(14):2115-9. doi: 10.1097/qad.0000000000001120.
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Keywords: Healthcare Costs, Human Immunodeficiency Virus (HIV), Medication
Bennette CS, Richards C, Sullivan SD
Steady increase in prices for oral anticancer drugs after market launch suggests a lack of competitive pressure.
The researchers used pharmacy claims for commercially insured individuals to examine trends in postlaunch prices over time for orally administered anticancer drugs recently approved by the Food and Drug Administration. They found that in the period 2007-13, inflation-adjusted per patient monthly drug prices increased 5 percent each year.
AHRQ-funded; HS022982.
Citation: Bennette CS, Richards C, Sullivan SD .
Steady increase in prices for oral anticancer drugs after market launch suggests a lack of competitive pressure.
Health Aff 2016 May;35(5):805-12. doi: 10.1377/hlthaff.2015.1145.
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Keywords: Cancer, Healthcare Costs, Medication
Lyles CR, Seligman HK, Parker MM
Financial strain and medication adherence among diabetes patients in an integrated health care delivery system: The Diabetes Study of Northern California (DISTANCE).
The researchers examined self-reported financial strain in relation to pharmacy utilization adherence data. Their analysis of survey, administrative, and electronic medical data from Kaiser Permanente Northern California found that 8 percent and 9 percent reported general and medication-specific financial strain. In adjusted models, general strain was significantly associated with primary nonadherence and refilling late and medication-specific strain was ssociated with primary nonadherence.
AHRQ-funded; HS022408.
Citation: Lyles CR, Seligman HK, Parker MM .
Financial strain and medication adherence among diabetes patients in an integrated health care delivery system: The Diabetes Study of Northern California (DISTANCE).
Health Serv Res 2016 Apr;51(2):610-24. doi: 10.1111/1475-6773.12346.
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Keywords: Diabetes, Medication, Patient Adherence/Compliance, Healthcare Costs, Healthcare Delivery
Raghavan R, Brown DS, Allaire BT
Medicaid expenditures on psychotropic medications for maltreated children: a study of 36 States.
The authors aimed to quantify the magnitude of Medicaid expenditures incurred in the purchase of psychotropic drugs for children with histories of abuse or neglect. They concluded that Medicaid agencies should focus their cost containment strategies on antidepressants and antimanic drugs, consider expanding primary care case management arrangements, and expand use of instruments such as the Child Behavior Checklist to identify and treat high-need children.
AHRQ-funded; HS020269.
Citation: Raghavan R, Brown DS, Allaire BT .
Medicaid expenditures on psychotropic medications for maltreated children: a study of 36 States.
Psychiatr Serv 2014 Dec;65(12):1445-51. doi: 10.1176/appi.ps.201400028.
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Keywords: Children/Adolescents, Healthcare Costs, Medicaid, Medication, Behavioral Health
Trish E, Joyce G, Goldman DP
Specialty drug spending trends among Medicare and Medicare Advantage enrollees, 2007-11.
The authors analyzed trends in specialty drug spending among Medicare beneficiaries ages sixty-five and older using 2007-11 pharmacy claims data. They found that annual specialty drug spending per beneficiary who used specialty drugs increased considerably during the study period, but specialty drugs accounted for less than ten percent of total drug spending per beneficiary. Additionally, in 2011, cost-sharing reductions under the Affordable Care Act significantly reduced specialty drug users' out-of-pocket burden, which decreased 26 percent from 2010.
AHRQ-funded; HS000046.
Citation: Trish E, Joyce G, Goldman DP .
Specialty drug spending trends among Medicare and Medicare Advantage enrollees, 2007-11.
Health Aff 2014 Nov;33(11):2018-24. doi: 10.1377/hlthaff.2014.0538.
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Keywords: Healthcare Costs, Health Insurance, Medicare, Medication
Starner CI, Alexander GC, Bowen K
Specialty drug coupons lower out-of-pocket costs and may improve adherence at the risk of increasing premiums.
The investigators examined insurers' role in maintaining the affordability and accessibility of specialty drugs while maximizing their value. They found that drug coupons accounted for $21.2 million of patients' $35.3 million annual out-of-pocket costs. In the vast majority of cases, coupons reduced monthly cost sharing to less than $250, a point at which patients were far less likely to abandon therapy with biologic anti-inflammatory drugs or with drugs for multiple sclerosis. They highlighted that, by reducing cost sharing, coupons may also circumvent efforts to encourage patients to use the most cost-effective drugs.
AHRQ-funded; HS018960.
Citation: Starner CI, Alexander GC, Bowen K .
Specialty drug coupons lower out-of-pocket costs and may improve adherence at the risk of increasing premiums.
Health Aff 2014 Oct;33(10):1761-9. doi: 10.1377/hlthaff.2014.0497.
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Keywords: Healthcare Costs, Health Insurance, Medication, Patient Adherence/Compliance
Crisp GD, Roberts AW, Esserman DA
The University of North Carolina's Health Care Pharmacy Assistance Program.
This study examined a program providing financial assistance to uninsured residents of North Carolina who need prescription medications. It found that from 2009 to 2011, the program served 7,180 patients in 81 counties. These patients received a mean of 23 prescriptions at an average cost of $754 per recipient per year.
AHRQ-funded; HS000032
Citation: Crisp GD, Roberts AW, Esserman DA .
The University of North Carolina's Health Care Pharmacy Assistance Program.
N C Med J. 2014 Sep-Oct;75(5):303-9..
Keywords: Healthcare Costs, Uninsured, Medication, Healthcare Utilization
Sarpong EM
AHRQ Author: Sarpong EM
The impact of obesity on medication use and expenditures among nonelderly adults with asthma.
The author examined the impact of obesity on medication use and expenditures among nonelderly adults with asthma using the Medical Expenditure Panel Survey. He found that obese classes II/III individuals were more likely to have current asthma, seek treatment for asthma, use more medications, and have higher medication and health care expenditures compared with normal weight individuals. His results suggested that reduction in body weight may help reduce health resource use and expenditures for nonelderly adults with asthma.
AHRQ-authored.
Citation: Sarpong EM .
The impact of obesity on medication use and expenditures among nonelderly adults with asthma.
J Health Care Poor Underserved 2014 Aug;25(3):1245-61. doi: 10.1353/hpu.2014.0142.
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Keywords: Asthma, Healthcare Costs, Medical Expenditure Panel Survey (MEPS), Medication, Obesity