Impact of 3 Tier Drug Copays On Use and Spending: Final Progress Report Final rept. (Sept. 16, 2002-Aug. 31, 2005)

摘要

The purpose is to evaluate the impact of a three-tier formulary on utilization and spending on prescription drugs and medical care. Many US health plans are trying to restrain rapid growth in their prescription drug costs by introducing three-tier formularies. Under this policy, a plan labels certain brand medications non-preferred and requires higher patient copayments for those medications. The policy has important financial and clinical implications for patients, depending on their ability and willingness to switch medications. Tufts Health Plan (THP), a large managed care organization based in New England, started introducing its three-tier formulary on January 1, 2000. This quasi-experimental study uses a pretest-posttest with comparison group design. Members whose employer adopted the three-tier benefit before March 1, 2000 are the experimental group, and the comparison group contains members whose employer adopted three-tier after March 1, 2000. We selected three drug classes for study: antidepressants, asthma medications, and cardiovascular medications.