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Association: Name: Economics of Population Health: Inaugural Conference of the American Society of Health Economists URL: http://healtheconomics.us
Citation: URL: http://www.allacademic.com/meta/p90444_index.html Direct Link: HTML Code:

Maciejewski, Matthew., Fortney, John., Stroupe, Kevin., Krein, Sarah. and Lui, Chuan-Fen. "The Effect of a Medication Copayment Increase on Metformin Adherence by Veterans with Diabetes" Paper presented at the annual meeting of the Economics of Population Health: Inaugural Conference of the American Society of Health Economists, TBA, Madison, WI, USA, Jun 04, 2006 <Not Available>. 2009-05-25 <http://www.allacademic.com/meta/p90444_index.html>

Maciejewski, M. L., Fortney, J. , Stroupe, K. , Krein, S. and Lui, C. , 2006-06-04 "The Effect of a Medication Copayment Increase on Metformin Adherence by Veterans with Diabetes" Paper presented at the annual meeting of the Economics of Population Health: Inaugural Conference of the American Society of Health Economists, TBA, Madison, WI, USA <Not Available>. 2009-05-25 from http://www.allacademic.com/meta/p90444_index.html

Publication Type: Abstract Abstract: Rationale: Copayment increases have been shown to affect health care demand in many settings, and adherence to essential medications may decrease when medication copayments rise. In 2002, the Veterans Administration (VA) increased medication copayments from $2.00 to $7.00 per 30-day prescription fill. Objectives: To examine whether adherence to metformin by veterans with diabetes changed between 2001-2003 when medication copayments increased in 2002. A subset of veterans who were exempt from medication copayments were expected to have less price-elastic demand for medications than a subset of veterans who were required to pay medication copayments. Methodology: VA data on demographic and risk characteristics of veterans were obtained from VA administrative data. Medication adherence was calculated based upon Pharmacy Benefits Management data that contain all prescriptions filled in VA pharmacies nation-wide. A cohort of 3,649 veterans being seen at the Ann Arbor, Hines, Little Rock and Seattle VA medical centers were included in the study. A generalized estimating equation was estimated for whether or not a veteran’s adherence changed after the copayment increased. Patient copayment “eligibility”, risk (via DCG), age, gender, race, marital status, hypertension status, number of diabetes medications, total number of medications, and site were controlled. Results: Nearly 18% of the entire sample was required to pay the medication copayment between 2001-2003, and these veterans were younger and lower risk than veterans who were exempt from medication copayments due to significant military service-related disability or low income. Veterans who were required to pay medication copayments were less adherence to metformin after the copay increase. Medication adherence did not change significantly for veterans who were exempt from copayments. Conclusions: Adherence to essential medications appears to be undermined by medication price increases. If medication non-adherence does result in higher downstream health care costs in other areas, increasing medication copayments may not be cost-effective for the VA system. Future VA copayment increases need to be considered very carefully.

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