A review of previous studies indicates that an increase in prescription drug cost sharing is associated with a decrease in drug spending and use of pharmacies; and for some chronic conditions, higher cost sharing is associated with greater use of expensive medical services, according to an article in the July 4 issue of JAMA: The Journal of the American Medical Association.
"'With recent increases in pharmacy spending, pharmacy benefit managers and health plans have adopted benefit changes designed to reduce pharmaceutical use or steer patients to less-expensive alternatives. The rapid proliferation of mail-order pharmacies, mandatory generic substitution, coinsurance plans, and multitiered formularies has transformed the benefit landscape," the authors write.
Dana P. Goldman, Ph.D., of RAND, Santa Monica, Calif., and colleagues analyzed previous studies to determine how cost-sharing features of prescription drug benefits may affect access to prescription drugs and how these features may affect medical spending and health outcomes. For this analysis, the researchers identified 132 articles examining the associations between prescription drug plan cost-containment measures, including co-payments, tiering, or coinsurance, pharmacy benefit caps or monthly prescription limits, formulary restrictions, and reference pricing, and outcomes, including pharmacy utilization and spending, medical care utilization and spending, and health outcomes.