Individuals who enrolled in health insurance on the Affordable Care Act's marketplaces had lower average drug spending and were less likely to use most medication classes than patients with employer-sponsored coverage, according to a study published in Health Affairs.
Individuals who enrolled in health insurance on the Affordable Care Act (ACA)’s marketplaces had lower average drug spending and were less likely to use most medication classes than patients with employer-sponsored coverage, according to a study published in Health Affairs.
The researchers used data on more than 1 million marketplace enrollees from Express Scripts and compared the characteristics and medication use between early and late marketplace enrollees and between all marketplace enrollees and those with employer-sponsored insurance.
Approximately a third of enrollees studied were considered early enrollees and 67.5% were considered later enrollees. The authors found that early enrollees tended to be older and live in areas with higher education and median family income. They were also more likely than later enrollees to have prior coverage through Express Scripts (43.5% compared to 27.6%).
“The insights gained by our analysis have implications for the marketing of ACA insurance plans, benefit design and out-of-pocket costs, as well as public health ramifications, such as expanding treatment for infectious diseases like HIV and hepatitis C,” lead author Julie M. Donohue, PhD, associate professor and vice chair for research in the University of Pittsburgh’s Department of Health Policy and Management, said in a statement.
According to the data from Express Scripts, marketplace enrollees were less likely than those with employer-sponsored coverage to have any drug usage during the study period (55% vs 63.5%), although early enrollees were significantly more likely than later enrollees to have drug usage (66.5% vs 50%).
Marketplace enrollees overall filled fewer prescriptions than the comparison group, and a greater proportion of their prescriptions were for generic drugs. As a result, Marketplace enrollees spent $73 on drugs compared with $93 by those with employer-sponsored coverage.
However, while Marketplace enrollees were less likely to use traditional medication classes, they had a significantly higher use of drugs to treat hepatitis C and HIV.
“From a public health perspective, our analysis indicates that the ACA is successfully helping more vulnerable populations with lower incomes gain access to medications needed to treat chronic and acute conditions,” Dr Donohue said. “Given the unprecedented expansion of insurance coverage with the ACA, close monitoring of its impact must continue.”
Examining Low-Value Cancer Care Trends Amidst the COVID-19 Pandemic
April 25th 2024On this episode of Managed Care Cast, we're talking with the authors of a study published in the April 2024 issue of The American Journal of Managed Care® about their findings on the rates of low-value cancer care services throughout the COVID-19 pandemic.
Listen
Dr Dalia Rotstein: Physicians Must Be Aware MS Affects People of All Backgrounds
April 24th 2024Dalia Rotstein, MD, MPH, emphazises the importance of awareness that multiple sclerosis (MS) impacts patients from various backgrounds as clinicians think through ways to improve access to care and research efforts in MS.
Read More
Navigating Health Literacy, Social Determinants, and Discrimination in National Health Plans
February 13th 2024On this episode of Managed Care Cast, we're talking with the authors of a study published in the February 2024 issue of The American Journal of Managed Care® about their findings on how health plans can screen for health literacy, social determinants of health, and perceived health care discrimination.
Listen
What We’re Reading: Abortion Privacy Rules; Alzheimer Drug Hurdles; Nursing Home Staffing Overhaul
April 23rd 2024New health privacy rules aim to protect patients and providers in an evolving abortion landscape; some physicians express concerns about efficacy, risks, and entrenched beliefs in treating Alzheimer disease; CMS addresses longstanding staffing deficits in nursing homes.
Read More
Award-Winning Poster Presentations From AMCP 2024
April 23rd 2024At the Academy of Managed Care Pharmacy (AMCP) 2024 annual meeting, multiple poster presentations concerned with health equity, data collection, glucagon-like peptide-1 agonists, and more were acknowledged for their originality, relevance, clarity, bias, and quality.
Read More