The effects of health plan copayments on adherence to oral diabetes medication and health resource utilization

J Occup Environ Med. 2008 May;50(5):535-41. doi: 10.1097/JOM.0b013e31816ed011.

Abstract

Objective: To assess the effects of copayments on oral diabetes medication adherence, health resource utilization, and expenditure.

Methods: Retrospective, observational analysis of medical and pharmacy claims data from PPG Industries employees, retirees, and dependents (2003-2005). Average monthly copayments were stratified low (US$0-9), medium (US$10-19), or high (US$20+).

Results: In 2052 individuals, adherence to oral diabetes medication was highest for the low copayment group for both age groups >or=65 years; 84% low, 77% medium, 64% high (P < 0.0001) and <65 years; 74% low, 71% medium, 55% high (P < 0.0001). For patients <65 years, total health care expenditure was 22% lower in the low versus high copayment group (P = 0.024), resulting in average savings of US $3116 per patient per year. Risk of hospitalization was significantly lower in the low versus the high copayment group for patients >or=65 years of age.

Conclusions: High copayments were associated with lower adherence to oral diabetes medications for all patients and higher total health care costs for patients less than 65.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Administration, Oral
  • Age Distribution
  • Aged
  • Deductibles and Coinsurance / economics*
  • Deductibles and Coinsurance / statistics & numerical data
  • Diabetes Mellitus, Type 2 / drug therapy
  • Diabetes Mellitus, Type 2 / economics*
  • Diagnostic Tests, Routine / economics
  • Diagnostic Tests, Routine / statistics & numerical data
  • Fees, Pharmaceutical
  • Female
  • Financing, Personal / classification
  • Financing, Personal / economics*
  • Financing, Personal / statistics & numerical data*
  • Health Expenditures
  • Health Resources / statistics & numerical data
  • Humans
  • Hypoglycemic Agents / economics*
  • Hypoglycemic Agents / therapeutic use
  • Male
  • Middle Aged
  • Patient Compliance / statistics & numerical data*
  • Retrospective Studies
  • United States

Substances

  • Hypoglycemic Agents