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319731
Giving providers access to formulary drug cost information - association with patients' drug costs and medication use


Tuesday, November 3, 2015 : 11:10 a.m. - 11:30 a.m.

Chien-Wen Tseng, MD MPH, Department of Family Medicine and Community Health, University of Hawaii John A. Burns School of Medicine, Honolulu, HI
Deborah Juarez, ScD, Daniel K. Inouye College of Pharmacy, University of Hawaii, Honolulu, HI
Grace Lin, MD MAS, Department of Medicine, University of California, San Francisco, San Francisco, CA
James Davis, PhD, Biostatistics Core, John A. School of Medicine, University of Hawaii, Honolulu, HI
Jinoos Yazdany, MD MPH, Division of Rheumatology, Department of Medicine, University of California, San Francisco, San Francisco, CA
Qimei He, PhD, Pacific Health Research and Education Institute, Honolulu, HI
Allison Imamura, Cancer Prevention & Control Res/FSPH & JCCC, University of California, Los Angeles, Los Angeles, CA
Chen Randi, MS, Pacific Health Research and Education Institute, Honolulu, HI
Adams Dudley, MD MBA, Division of Pulmonary and Critical Care, Department of Medicine, University of California, San Francisco, San Francisco, CA
  
Audio (mp3) recording Recorded Presentation (mp4)
Objectives. Providers wish to help patients with drug costs but often lack cost information. We examined the association between giving physicians formulary and cost information with changes in their diabetes patients’ drug costs and use. 

 

Study design.   A longitudinal non-randomized evaluation of the Prescribing Guide (PG), a free resource summarizing health plan formularies and copayments for 16 common conditions. All adult primary care physicians in Hawaii were offered the PG and could enroll for regular updates and access at www.PrescribingGuide.com.

Methods.  We analyzed prescription claims from a major health plan for 5,883 diabetes patients from 2007 to 2009.  Patients were linked to 299 “main prescribing” physicians, who on average, accounted for >88% of patients’ prescriptions and drug costs. We compared changes in drug costs and use for patients whose main physician received the PG (study) versus otherwise (control).

    

Results.  In multivariate analyses controlling for provider specialty, both groups experienced similar increases in number of prescriptions (3.2 vs. 2.7 increase, p=0.24), and days supply of medications over time (141 vs. 129 increase, p=0.40). However, control versus study patients showed greater increases in yearly total drug costs of $207 per patient ($791 vs. $584 increase, p=0.02) and in 30-day supply costs ($9.40 vs. $6.08 increase, p=0.03).  Copayment changes did not differ per year ($41 vs. $31 increase, p=0.36) and 30-day supply (-$0.23 vs. -$0.19 decrease, p=0.99).

Conclusion. A low-cost web-based intervention to give providers formulary and drug cost information was associated with lower increases in total drug costs but not lower copayments.  

Learning Areas:

Communication and informatics
Provision of health care to the public
Public health or related public policy
Public health or related research

Learning Objectives:
Explain how giving providers better access to formulary and drug cost information affects their patients' drug costs and medication use.

Keyword(s): Medical Care, Policy/Policy Development

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am an Associate Professor and health economist at the University of Hawaii at Hilo College of Pharmacy. I have a doctorate in health economics from the Harvard School of Public Health and have been engaged in health services research for the past twenty years. I have been an investigator and author on multiple research studies involving medication adherence and cost.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

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