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Preventive drug lists as tools for managing asthma medication costs
Melissa B Gilkey1, Lauren A Cripps, Rachel S Gruver
1Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina, Campus Box 7440, Chapel Hill, NC 27599.
The American Journal of Managed Care
|February 15, 2020
Summary
Preventive drug lists (PDLs) can help high-deductible health plan (HDHP) members manage asthma medication costs, but awareness and formulary limitations pose challenges. Improved implementation and member education are needed for PDLs to be fully effective.
Area of Science:
- Health economics
- Pharmaceutical policy
- Respiratory medicine
Background:
- Value-based insurance design aims to reduce healthcare costs for high-deductible health plan (HDHP) members.
- Preventive drug lists (PDLs) cover certain medications at reduced cost before deductibles are met.
- The impact of PDLs on patient experiences, particularly for chronic conditions like asthma, is not well understood.
Purpose of the Study:
- To evaluate the benefits and challenges experienced by members using PDLs for managing asthma-related costs.
- To understand patient perspectives on the effectiveness and accessibility of PDLs.
Main Methods:
- Qualitative interview study with 22 US adults enrolled in HDHPs with PDLs and who have asthma.
- Interviews conducted via telephone in 2018.
- Thematic content analysis used to analyze interview data.
Main Results:
- Members reported financial benefits and improved adherence to preventive medications due to PDLs.
- Barriers included PDLs not covering all asthma medications or offering limited cost coverage due to formulary restrictions.
- Lack of member awareness about PDLs and the exclusion of non-medication costs presented significant challenges.
Conclusions:
- PDLs show promise for aiding families in HDHPs with medication costs and asthma management.
- Member awareness of PDLs and their specific benefits is crucial for utilization.
- Addressing limitations in coverage and improving member education are essential to maximize the potential of PDLs.
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