Healthcare Costs Associated with Antiretroviral Adherence Among Medicaid Patients

Pruitt, Zachary; Robst, John; Langland‐Orban, Barbara; Brooks, Robert G.

doi:10.1007/s40258-014-0138-1

Cited by 10 publications

(10 citation statements)

References 22 publications

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“…Though the prevalence of optimal adherence in this study is low compared to other studies of older PLWH [27–31], the cART adherence measure, study sample, and the length of the observation period in this study differed significantly from these other studies. However, the prevalence of optimal adherence among this sample of Medicaid-enrolled older PLWH is similar to the prevalence of optimal adherence (17–33 %) reported by other studies on age-diverse Medicaid samples [21, 39–41]. The low level of optimal adherence among older PLWH in this study underscores the need for adherence counseling and support programs targeted towards older PLWH enrolled in Medicaid.…”

Section: Discussionsupporting

confidence: 83%

Correlates of Combination Antiretroviral Adherence Among Recently Diagnosed Older HIV-Infected Adults Between 50 and 64 years

Abara

Adekeye

et al. 2016

AIDS Behav

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Optimal adherence to combination antiretroviral therapy is essential to the health of older people living with HIV (PLWH), however, the literature on adherence and aging is limited. Using Medicaid data from 29 states (N = 5177), we explored correlates of optimal adherence among older PLWH. The prevalence of optimal adherence was low (32 %) in this study. Males were more adherent than females (APR = 1.11, 95 % CI 1.02–1.21, P = 0.0127); persons with three or more co-morbidities (APR = 0.67, 95 % CI 0.60–0.74, P < 0.001), two co-morbidities (APR = 0.86, 95 % CI 0.75–0.98, P = 0.0319) and one co-morbidity (APR = 0.82, 95 % CI 0.73–0.92, P = 0.0008) were less adherent than those without any co-morbidity; and residents of rural areas (APR = 0.90, 95 % CI 0.63–0.98, P = 0.0385) and small metropolitan areas (APR = 0.82, 95 % CI 0.72–0.94, P = 0.0032) were less adherent than residents of large metropolitan areas. There were no racial differences in optimal adherence. Targeted interventions that provide adherence support, case management, and peer navigation services may be of benefit in achieving optimal adherence in this population.

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Section: Discussionsupporting

confidence: 83%

Correlates of Combination Antiretroviral Adherence Among Recently Diagnosed Older HIV-Infected Adults Between 50 and 64 years

Abara

Adekeye

et al. 2016

AIDS Behav

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“…The economic impact of medication non-adherence for patients with HIV and AIDS reported among all three studies was similar. 26 32 62 Two of the three studies examined the costs only for HIV, 26 32 while Pruitt et al 62 assessed the cost in AIDS as well as HIV. The total unadjusted costs for non-adherent HIV patients ranged from $16 957 to $30 068 with one study further categorising patients with HIV as having either a high viral load or low viral load.…”

Section: Resultsmentioning

confidence: 99%

“… 26 The total cost of non-adherence in AIDS was $30 523. 62 All studies used comparable indicators (total cost, inpatient cost, outpatient cost, pharmacy cost) to determine the cost of non-adherence.…”

Section: Resultsmentioning

confidence: 99%

Economic impact of medication non-adherence by disease groups: a systematic review

et al. 2018

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ObjectiveTo determine the economic impact of medication non-adherence across multiple disease groups.DesignSystematic review.Evidence reviewA comprehensive literature search was conducted in PubMed and Scopus in September 2017. Studies quantifying the cost of medication non-adherence in relation to economic impact were included. Relevant information was extracted and quality assessed using the Drummond checklist.ResultsSeventy-nine individual studies assessing the cost of medication non-adherence across 14 disease groups were included. Wide-scoping cost variations were reported, with lower levels of adherence generally associated with higher total costs. The annual adjusted disease-specific economic cost of non-adherence per person ranged from $949 to $44 190 (in 2015 US$). Costs attributed to ‘all causes’ non-adherence ranged from $5271 to $52 341. Medication possession ratio was the metric most used to calculate patient adherence, with varying cut-off points defining non-adherence. The main indicators used to measure the cost of non-adherence were total cost or total healthcare cost (83% of studies), pharmacy costs (70%), inpatient costs (46%), outpatient costs (50%), emergency department visit costs (27%), medical costs (29%) and hospitalisation costs (18%). Drummond quality assessment yielded 10 studies of high quality with all studies performing partial economic evaluations to varying extents.ConclusionMedication non-adherence places a significant cost burden on healthcare systems. Current research assessing the economic impact of medication non-adherence is limited and of varying quality, failing to provide adaptable data to influence health policy. The correlation between increased non-adherence and higher disease prevalence should be used to inform policymakers to help circumvent avoidable costs to the healthcare system. Differences in methods make the comparison among studies challenging and an accurate estimation of true magnitude of the cost impossible. Standardisation of the metric measures used to estimate medication non-adherence and development of a streamlined approach to quantify costs is required.PROSPERO registration numberCRD42015027338.

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“…Disease phenomenon [21][22][23][24].In addition, DRGs also has some practices in China, but we think it is not suitable for China's county-level regions, especially the central and western regions where the economy and medical care are underdeveloped.Relatively speaking, the current stage of medical insurance informatization in these areas and the standardization of hospital information systems are uneven, which leads to inadequate supervision and brings di culties to the collection of large amounts of data required for DRGs coding.Second, after the implementation of DRGs, doctors may increase their income by over-diagnosing and changing the level of surgery, and cannot really save medical insurance funds; when facing the same price, patients are more likely to prefer county-level hospitals with better medical conditions. Nor can it change the current contradiction between countylevel hospitals and primary health service centers, which runs counter to the reform goals;The total prepaid execution cost is low, and it can effectively control the medical cost, but its disadvantage is that it is di cult to ensure the quality of medical treatment and may cause medical institutions to reject patients [25][26][27][28].The performance-based payment method is usually implemented together with other payment methods. The purpose is to control costs while ensuring the quality of medical services.…”

Section: Comparison With Other Medical Insurance Payment Methodsmentioning

confidence: 99%

The Impact of China's Total Medical Insurance Package Payment Based on Compact County Medical Community and Its Implications for Medical Insurance Funds: Evidence from Y County, China

Liu¹,

Yang

et al. 2020

Preprint

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Background:Due to the irrational structure of medical and health resources, uneven distribution, and low level of grassroots services, traditional medical insurance payment methods in China’s underdeveloped areas have not been fully utilized in regulating medical service behaviors and guiding the allocation of medical resources. The medical insurance fund of many regions collapsed, the fund balance rate and compensation rate decreased year by year, and the medical expenses rose rapidly, which seriously affected the enthusiasm of the insured residents. As a results,the sustainable development of the medical insurance fund faced many difficulties and challenges.Based on this, we want to design a medical insurance policy suitable for underdeveloped areas in China to improve the capacity and efficiency of health services and maintain the stability of medical insurance funds.Methods:Collected medical insurance data of Y County in China from 2018 to 2019.The interruption time series(ITS) was used to evaluate the utilization of medical insurance funds in county-level hospitals, primary health service centers, and hospitals outside the medical community.Results:Inpatient expenditure(IE) per capita,out-of-pocket inpatient expenditure(OIE) per capita,and medical insurance expenditure (MIE)per capita in county-level hospitals increased by 84.682, 6.564 and 62.302 yuan per month respectively after the reform; Number of annul discharges persons(NOADP)from basic health service centers increased by 36.899 per month after the reform; IE per capita and MIE per capita increased by 18.624 yuan and 15.767 yuan per month on average after the reform; the residents hospitalized outside CCMC decreased by 9.545 per month on average after the reform. Conclusions:China should further implement the CCMC-based TMIPPM reform to control medical expenses and maintain the stability of medical insurance funds in in more trials.

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Healthcare Costs Associated with Antiretroviral Adherence Among Medicaid Patients

Abstract: The results show that the relationship of ART adherence to healthcare costs is more complex than previously reported.

Cited by 10 publications

References 22 publications

Correlates of Combination Antiretroviral Adherence Among Recently Diagnosed Older HIV-Infected Adults Between 50 and 64 years

Correlates of Combination Antiretroviral Adherence Among Recently Diagnosed Older HIV-Infected Adults Between 50 and 64 years

Economic impact of medication non-adherence by disease groups: a systematic review

The Impact of China's Total Medical Insurance Package Payment Based on Compact County Medical Community and Its Implications for Medical Insurance Funds: Evidence from Y County, China

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