State Medicaid Reimbursement for Medications for Chronic Hepatitis C Infection from 2012 through 2015

Lu, Christine Y.; Zhang, Fang; Golonski, Nicole; Lupton, Caitlin; Jeffrey, Paul L.; Wagner, Anita K.

doi:10.1016/j.jval.2017.09.011

Cited by 14 publications

(14 citation statements)

References 21 publications

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“…A wide range of important and highly controversial health policies are regulated primarily at the state level, including abortion, vaccination, and physician‐assisted death, but the most vital and wide‐ranging of state‐level policies are public insurance programs, such as Medicaid . State limits on the eligibility and the extent of coverage through Medicaid affect management of liver disease, treatment of hepatitis C virus, and likelihood of being placed on the waiting list . Beyond the statutory authority of states, there are practical considerations that support a state‐based liver distribution scheme.…”

Section: Discussionmentioning

confidence: 99%

“…(24)(25)(26)(27)(28) State limits on the eligibility and the extent of coverage through Medicaid affect management of liver disease, treatment of hepatitis C virus, and likelihood of being placed on the waiting list. (21,29,30) Beyond the statutory authority of states, there are practical considerations that support a statebased liver distribution scheme. Patient referrals and listings largely follow state borders: In 2017, 85% of adult liver transplant wait-list candidates were listed either in their own state or DSA (for those residing in a state without a center).…”

Section: Discussionmentioning

confidence: 99%

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State‐Based Liver Distribution: Broad Sharing With Less Harm to Vulnerable and Underserved Communities Compared With Concentric Circles

Lynch

Sheng

et al. 2019

Liver Transpl

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Allocation of livers for transplantation faces regulatory pressure to move toward broader sharing. A current proposal supported by the United Network for Organ Sharing Board of Directors relies on concentric circles, but its effect on socioeconomic inequities in access to transplant services is poorly understood. In this article, we offer a proposal that uses the state of donation as a unit of distribution, given that the state is a recognized unit of legal jurisdiction and socioeconomic health in many contexts. The Scientific Registry of Transplant Recipients liver simulated allocation model algorithm was used to generate comparative estimates of regional transplant volume and the impact of these considered changes with regard to vulnerable and high‐risk patients on the waiting list and to disparities in wait‐list access. State‐based liver distribution outperforms the concentric circle models in overall system efficiency, reduced discards, and minimized flights for organs. Furthermore, the efflux of organs from areas of greater sociodemographic vulnerability and lesser wait‐list access is more than 2‐fold lower in a state‐based model than in concentric circle alternatives. In summary, we propose that a state‐based system offers a legally defensible, practical, and ethically sound alternative to geometric zones of organ distribution.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

State‐Based Liver Distribution: Broad Sharing With Less Harm to Vulnerable and Underserved Communities Compared With Concentric Circles

Lynch

Sheng

et al. 2019

Liver Transpl

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“…The ability to include managed care data is essential for accurate estimation of Medicaid expansion effects. In line with recently published studies using the SDUD (Lu et al., ; Wen, Hockenberry et al., ; Wen, Schackman et al., ), we restrict our data to the post‐2010 period (2011 to 2015). We note our inability to study a longer pretreatment period as a limitation.…”

Section: Data Variables and Methodsmentioning

confidence: 98%

The Effect of Public Insurance Expansions on Substance Use Disorder Treatment: Evidence from the Affordable Care Act

Maclean¹,

Saloner²

2018

J Policy Anal Manage

108

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We examine the effect of Medicaid expansion under the Affordable Care Act (ACA) on substance use disorder (SUD) treatment utilization and financing. We combine data on admissions to specialty facilities and Medicaid‐reimbursed prescriptions for medications commonly used to treat SUDs in nonspecialty outpatient settings with an event‐study design. Several findings emerge from our study. First, among patients receiving specialty care, Medicaid coverage and payments increased. Second, the share of patients who were uninsured and who had treatment paid for by state and local government payments declined. Third, private insurance coverage and payments increased. Fourth, expansion also increased prescriptions for SUD medications reimbursed by Medicaid. Fifth, we find suggestive evidence that admissions to specialty treatment may have increased one or more years post‐expansion. However, this finding is sensitive to specification and we observe differential pretrends between the treatment and comparison groups. Thus, our finding for admissions should be interpreted with caution.

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“…Even within the United States, there is evidence for variation in uptake that may influence the impact of these policies. 36 Given these differences, there is a need to evaluate the impact of these approaches to better understand the real-world implications on spending and patient outcomes.…”

Section: Discussionmentioning

confidence: 99%

Spending on Hepatitis C Antivirals in the United States and Canada, 2014 to 2018

et al. 2020

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Objectives: Hepatitis C virus (HCV) antivirals have been shown to be highly effective with minimal adverse effects, but they are costly. Little is known about the national spending on this drug class in either Canada or the United States, 2 countries with different drug pricing regulations. Thus the objective of this study was to compare drug expenditure on HCV medications in the United States and Canada.Methods: This was a retrospective cross-sectional study using the IQVIA National Sales Perspectives (United States) and Geographic Prescription Monitor (Canada) databases, which contains prescription transactions from American and Canadian pharmacies. All prescription claims for the period between January 1, 2014, and June 30, 2018, were used to describe HCV antiviral expenditure in both countries.

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State Medicaid Reimbursement for Medications for Chronic Hepatitis C Infection from 2012 through 2015

Cited by 14 publications

References 21 publications

State‐Based Liver Distribution: Broad Sharing With Less Harm to Vulnerable and Underserved Communities Compared With Concentric Circles

State‐Based Liver Distribution: Broad Sharing With Less Harm to Vulnerable and Underserved Communities Compared With Concentric Circles

The Effect of Public Insurance Expansions on Substance Use Disorder Treatment: Evidence from the Affordable Care Act

Spending on Hepatitis C Antivirals in the United States and Canada, 2014 to 2018

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