The Effects of Health Plan Copayments on Adherence to Oral Diabetes Medication and Health Resource Utilization

• Published in: Journal of occupational and environmental medicine Vol. 50; no. 5; pp. 535 - 541
• Main Authors: Colombi, Alberto M., Yu-Isenberg, Kristina, Priest, Julie
• Format: Journal Article
• Language: English
• Published: Hagerstown, MD Lippincott Williams & Wilkins 01-05-2008; The American College of Occupational and Environmental Medicine; Lippincott Williams & Wilkins Ovid Technologies
• Subjects: Administration, Oral; Age Distribution; Aged; Biological and medical sciences; Deductibles and Coinsurance - economics; Deductibles and Coinsurance - statistics & numerical data; Diabetes; Diabetes Mellitus, Type 2 - drug therapy; Diabetes Mellitus, Type 2 - economics; Diabetes. Impaired glucose tolerance; Diagnostic Tests, Routine - economics; Diagnostic Tests, Routine - utilization; Effects; Endocrine pancreas. Apud cells (diseases); Endocrinopathies; Etiopathogenesis. Screening. Investigations. Target tissue resistance; Fees, Pharmaceutical; Female; Financing, Personal - classification; Financing, Personal - economics; Financing, Personal - statistics & numerical data; Health care expenditures; Health Expenditures; Health Resources - utilization; Humans; Hypoglycemic Agents - economics; Hypoglycemic Agents - therapeutic use; Male; Medical sciences; Middle Aged; Occupational health; ORIGINAL ARTICLES; Patient Compliance - statistics & numerical data; Retrospective Studies; United States; United States; North America; America; Endocrinopathy; Human; Drug compliance; Health insurance; Treatment; Diabetes mellitus; Welfare aids; Oral administration; Pharmacotherapy; Occupational medicine
• ISSN: 1076-2752; 1536-5948
• DOI: 10.1097/jom.0b013e31816ed011

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 ≥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 ≥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.