AJMC® Research Roundup: July 2019

Hi, I’m Christina Mattina for The American Journal of Managed Care^®. Here are 5 findings from research published in the July issue.

What Are the Potential Savings From Steering Patients to Lower-Priced Providers? A Static Analysis

1. A claims analysis found variation in prices for shoppable services, especially lab testing, and determined that switching patients to providers with the median price in their market could result in substantial savings on lab tests, imaging, and medical equipment.

Number of Manufacturers and Generic Drug Pricing From 2005 to 2017

2. By evaluating both price changes and pharmacy claims counts for generic drugs, researchers found that drug price increases are now affecting widely used multisource drugs, not just single-source drugs, which suggests that prices are becoming less responsive to competition.

Insurers’ Perspectives on MA Value-Based Insurance Design Model

3. Most insurers that were eligible to join the Medicare Advantage VBID model test did not do so, citing concerns around return on investment, information technology problems, and model parameters. Those that did participate often encountered these barriers but then overcame them.

Heroin and Healthcare: Patient Characteristics and Healthcare Prior to Overdose

4. Nearly all insured patients who overdose on heroin accessed healthcare services in the 6 months before their overdose, indicating opportunities to introduce prevention efforts in outpatient settings, and emphasizing the importance of coordinated care.

Impact of a Co-pay Accumulator Adjustment Program on Specialty Drug Adherence

5. Implementation of a co-pay accumulator adjustment program was associated with reduced adherence to specialty autoimmune drugs and higher rates of treatment discontinuation. Although these programs can save employers money in the short term, lower adherence can result in greater medical spending over time.

To read all of these studies and more, visit AJMC.com.