The Association Between a Tiered Pharmacy Benefit Plan and Medication Usage, Health Status, and Disability Absence Days—One Employer’s Experience

Burton, Wayne N.; Chen, Chin‐Yu; Schultz, Alyssa B.; Edington, Dee W.

doi:10.1097/jom.0b013e31817e7bc1

Cited by 2 publications

(5 citation statements)

References 19 publications

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“…It is known that the degree of employee cost-sharing for a prescription may be associated with medication adherence. 46 It is not possible to evaluate such factors in the present study because of the small sample size in each study year. Finally, medication prescriptions may not equate with the employee actually taking the medication.…”

Section: Limitationsmentioning

confidence: 88%

The Association Between Achieving Low-Density Lipoprotein Cholesterol (LDL-C) Goal and Statin Treatment in an Employee Population

Burton

Chen

Schultz

et al. 2010

Population Health Management

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Statin medications are recommended for patients who have not achieved low-density lipoprotein cholesterol (LDL-C) goals through lifestyle modifications. The objective of this retrospective observational study was to examine statin medication usage patterns and the relationship with LDL-C goal levels (according to Adult Treatment Panel III guidelines) among a cohort of employees of a major financial services corporation. From 1995 to 2004, a total of 1607 executives participated in a periodic health examination program. An index date was assigned for each study participant (date of their exam) and statin medication usage was determined from the pharmacy claims database for 365 days before the index date. Patients were identified as adherent to statins if the medication possession ratio was > or =80%. In all, 150 (9.3%) executives filled at least 1 statin prescription in the 365 days prior to their exam. A total of 102 statin users (68%) were adherent to statin medication. Among all executives who received statin treatment, 70% (odds ratio [OR] = 2.30, 95% confidence interval [CI] = 1.82, 2.90) achieved near-optimal (<130 mg/dL) and 30% (OR = 1.78, 95% CI = 1.15, 2.76) achieved optimal (<100 mg/dL) LDL-C goals, which is significantly higher than the rates among statin nonusers (55% and 21%). Adherent statin users were more likely to achieve recommended near-optimal LDL-C goals compared to statin nonusers (overall P = 0.002; adherent: OR = 2.75, 95% CI = 1.662, 4.550), while nonadherent statin users were more likely to achieve the optimal goal compared to statin nonusers (OR = 2.223; CI = 1.145, 4.313). Statin usage was associated with improvements in LDL-C goal attainment among executives who participated in a periodic health examination. Appropriate statin medication adherence should be encouraged in working populations in order to achieve LDL-C goals.

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Section: Limitationsmentioning

confidence: 88%

The Association Between Achieving Low-Density Lipoprotein Cholesterol (LDL-C) Goal and Statin Treatment in an Employee Population

Burton

Chen

Schultz

et al. 2010

Population Health Management

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“…The HRS is a biannual longitudinal study of 37,000 American adults aged 51 or older from 23,000 households. The study collects information on demographic and socioeconomic characteristics including health, insurance coverage, and medical care utilization [41] 6 [21], 7 [32], 8 [33], 9 [34], 10 [35], 11 [36], 12 [37], 13 [38], 14 [39], 15 [40], 16 [41],…”

Section: Resultsmentioning

confidence: 99%

“…One of the measures employed is to investigate whether there is a change in work absenteeism as a health outcome measure, based on previous findings that showed a relationship between pharmacological treatment and reduction of worker productivity loss due to illness for some diseases. The study by Burton et al [32] did not point out any difference in the outcome in its evaluation.…”

Section: Discussionmentioning

confidence: 99%

“…Burton et al [32] took an interesting approach when using temporary disability licenses as an indicator of the effects of the change in medicines co-payment from two to three levels with increasing amounts of the patient’s share in these levels. One of the measures employed is to investigate whether there is a change in work absenteeism as a health outcome measure, based on previous findings that showed a relationship between pharmacological treatment and reduction of worker productivity loss due to illness for some diseases.…”

Section: Discussionmentioning

confidence: 99%

“…Also in the aforementioned Burton et al [32] study, the other indicator used was the worker’s perception of his/her general health status. Although not mentioned by the authors, the indicator of self-evaluation of general health status is recognized as a good approximation of the individual’s health [42, 43] and is, therefore, a good indicator, mainly regarding the attribute of validity.…”

Section: Discussionmentioning

confidence: 99%

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Use of health outcome and health service utilization indicators as an outcome of access to medicines in Brazil: perspectives from a literature review

et al. 2019

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BackgroundTo guarantee the right to health, the health system must also ensure access to medicines. Several financial arrangements to provide these technologies are implemented and range from the direct (either total or partial) to indirect payment by the patient, being necessary to evaluate its effect on access to medicines. However, to ensure access to medicines is not just about ensuring its availability, as this only materializes in its use. Thus, evaluation studies of interventions in access to medicines have been using indicators related to the health results and use of health services as its outcomes. Furthermore, as this relationship is not direct, it is important to critically assess the adequacy of these tools to measure this phenomenon and, additionally, the ability to use it in the Brazilian scenario. Therefore, this study sought to identify, describe, and analyze the use of these indicators as medicine access outcomes, through a review of the scientific literature.MethodsAn extensive literature review was done using a bibliographic database for a systematic review. The references were selected based on inclusion and exclusion criteria, and the indicators from the papers retained were analyzed using the parameters of validity, measurability, reliability, and relevance.ResultsWe have analyzed over 12,000 references of which 30 references were included, describing the use of 49 health outcomes and health service use indicators. The majority reported the use of health service utilization measures. In our evaluation, the best indicators for assessing the effects of co-payment intervention on access are the ones aimed at specific populations or symptomatic health conditions in which the response to the therapeutic treatment is known and occurs in a short period of time. It was evident the lack of information on the indicators analyzed as well as the limitation of the Brazilian secondary databases for its calculation.ConclusionsThis research showed the variety and heterogeneity of the indicators used in scientific studies. The best indicators for access to medicines are sought to measure the use of health services for symptomatic health conditions that are quickly responsive to pharmacological treatment, while the indicators related to worker productivity loss was the most suitable for health outcomes.Electronic supplementary materialThe online version of this article (10.1186/s40985-019-0115-1) contains supplementary material, which is available to authorized users.

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The Association Between a Tiered Pharmacy Benefit Plan and Medication Usage, Health Status, and Disability Absence Days—One Employer’s Experience

Abstract: Although the degree of employee cost-sharing for prescription medications increased from 2000 to 2004 and the utilization of some medication categories decreased, there was no observed association with overall employee health status or STD absenteeism during the 5-year study period.

Cited by 2 publications

References 19 publications

The Association Between Achieving Low-Density Lipoprotein Cholesterol (LDL-C) Goal and Statin Treatment in an Employee Population

The Association Between Achieving Low-Density Lipoprotein Cholesterol (LDL-C) Goal and Statin Treatment in an Employee Population

Use of health outcome and health service utilization indicators as an outcome of access to medicines in Brazil: perspectives from a literature review

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