scholarly journals PHP65 THE IMPACT AND CHALLENGES OF INCLUDING PATIENT COST SHARING IN COST-EFFECTIVENESS ANALYSES FROM THE PAYER PERSPECTIVE

2009 ◽  
Vol 12 (3) ◽  
pp. A90
Author(s):  
DE Spackman ◽  
JD Campbell
Keyword(s):  
Cost Effectiveness ◽  
Cost Sharing ◽  
Patient Cost ◽  
Payer Perspective ◽  
The Impact

scholarly journals The Impact of Patient Cost-Sharing on the Poor: Evidence from Massachusetts

2012 ◽  
Author(s):  
Amitabh Chandra ◽  
Jonathan Gruber ◽  
Robin McKnight
Keyword(s):  
Cost Sharing ◽  
Patient Cost ◽  
The Poor ◽  
The Impact

scholarly journals Hypertension and diabetes treatment affordability and government expenditures following changes in patient cost sharing in the “Farmácia popular” program in Brazil: an interrupted time series study

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Isabel Cristina Martins Emmerick ◽  
Mônica Rodrigues Campos ◽  
Rondineli Mendes da Silva ◽  
Luisa Arueira Chaves ◽  
Andréa Dâmaso Bertoldi ◽  
...  
Keyword(s):  
Time Series ◽  
Cost Sharing ◽  
Interrupted Time Series ◽  
Government Expenditures ◽  
Patient Cost ◽  
Capita Expenditure ◽  
Per Capita ◽  
The Government ◽  
The Impact ◽  
Over Time

Abstract Background Increasing medicines availability and affordability is a key goal of Brazilian health policies. “Farmácia Popular” (FP) Program is one of the government’s key strategies to achieve this goal. Under FP, antihypertension (HTN) and antiglycemic (DM) medicines have been provided at subsidized prices in private retail settings since 2006, and free of charge since 2011. We aim to assess the impact of sequential changes in FP benefits on patient affordability and government expenditures for HTN and DM treatment under the FP, and examine their implications for public financing mechanisms and program sustainability. Methods Longitudinal, retrospective study using interrupted time series to analyze: HTN and DM treatment coverage; total and per capita expenditure; percentage paid by MoH; and patient cost sharing. Analyzes were conducted in the dispensing database of the FP program (from 2006 to 2012). Results FP has increased its coverage over time; by December 2012 FP covered on average 13% of DM and 11.5% of HTN utilization, a growth of over 600 and 1500%, respectively. The overall cost per treatment to the MoH declined from R$36.43 (R$ = reais, the Brazilian currency) to 18.74 for HTN and from R$33.07to R$15.05 for DM over the period analyzed, representing a reduction in per capita cost greater than 50%. The amount paid by patients for the medicines covered increased over time until 2011, but then declined to zero. We estimate that to treat all patients in need for HTN and DM in 2012 under FP, the Government would need to expend 97% of the total medicines budget. Conclusions FP rapidly increased its coverage in terms of both program reach and proportion of cost subsidized during the period analyzed. Costs of individual HTN and DM treatments in FP were reduced after 2011 for both patients (free) and government (better negotiated prices). However, overall FP expenditures by MoH increased due to markedly increased utilization. The FP is sustainable as a complementary policy but cannot feasibly substitute for the distribution of medicines by the SUS.

scholarly journals The impact of patient cost-sharing on low-income populations: Evidence from Massachusetts

2014 ◽  
Vol 33 ◽  
pp. 57-66 ◽  
Author(s):  
Amitabh Chandra ◽  
Jonathan Gruber ◽  
Robin McKnight
Keyword(s):  
Low Income ◽  
Cost Sharing ◽  
Patient Cost ◽  
The Impact

scholarly journals Affordable False Teeth: The Effects of Patient Cost Sharing on Denture Utilization and Subjective Chewing Ability

2016 ◽  
Vol 16 (3) ◽  
pp. 1387-1438 ◽  
Author(s):  
Michihito Ando ◽  
Reo Takaku
Keyword(s):  
Cost Sharing ◽  
Social Benefit ◽  
Utilization Rate ◽  
Randomization Tests ◽  
Japanese Study ◽  
Patient Cost ◽  
Chewing Ability ◽  
Using Data ◽  
The Impact ◽  
Complementary Analysis

Abstract We evaluate the impact of patient cost sharing on the use of dentures and subjective chewing ability exploiting a sharp reduction in the coinsurance rate, the percentage of costs born by the user, from 30 % to 10 % at the age of 70 with a regression discontinuity design. Using data from the Japanese Study of Aging and Retirement (JSTAR), we find that the utilization rate of dentures increases from approximately 50 % to 63 % around the threshold, implying that the extensive margin elasticity of denture usage with respect to the coinsurance rate is about –0.41. In addition, we find this jump is almost entirely due to the change in the rate among women. On the other hand, we do not find a significant improvement in self-reported chewing ability, although chewing ability may not be the only social benefit from dentures. Our empirical findings are also confirmed by complementary analysis with randomization tests.

scholarly journals Perspective and Costing in Cost-Effectiveness Analysis, 1974–2018

2020 ◽  
Vol 38 (10) ◽  
pp. 1135-1145 ◽  
Author(s):  
David D. Kim ◽  
Madison C. Silver ◽  
Natalia Kunst ◽  
Joshua T. Cohen ◽  
Daniel A. Ollendorf ◽  
...  
Keyword(s):  
Cost Effectiveness ◽  
Cost Saving ◽  
Productivity Loss ◽  
Quality Adjusted Life Year ◽  
Healthcare Sector ◽  
Disability Adjusted Life ◽  
Payer Perspective ◽  
The Cost ◽  
Disability Adjusted Life Year ◽  
The Impact

Abstract Objective Our objective was to examine perspective and costing approaches used in cost-effectiveness analyses (CEAs) and the distribution of reported incremental cost-effectiveness ratios (ICERs). Methods We analyzed the Tufts Medical Center’s CEA and Global Health CEA registries, containing 6907 cost-per-quality-adjusted-life-year (QALY) and 698 cost-per-disability-adjusted-life-year (DALY) studies published through 2018. We examined how often published CEAs included non-health consequences and their impact on ICERs. We also reviewed 45 country-specific guidelines to examine recommended analytic perspectives. Results Study authors often mis-specified or did not clearly state the perspective used. After re-classification by registry reviewers, a healthcare sector or payer perspective was most prevalent (74%). CEAs rarely included unrelated medical costs and impacts on non-healthcare sectors. The most common non-health consequence included was productivity loss in the cost-per-QALY studies (12%) and patient transportation in the cost-per-DALY studies (21%). Of 19,946 cost-per-QALY ratios, the median ICER was $US26,000/QALY (interquartile range [IQR] 2900–110,000), and 18% were cost saving and QALY increasing. Of 5572 cost-per-DALY ratios, the median ICER was $US430/DALY (IQR 67–3400), and 8% were cost saving and DALY averting. Based on 16 cost-per-QALY studies (2017–2018) reporting 68 ICERs from both the healthcare sector and societal perspectives, the median ICER from a societal perspective ($US22,710/QALY [IQR 11,991–49,603]) was more favorable than from a healthcare sector perspective ($US30,402/QALY [IQR 10,486–77,179]). Most governmental guidelines (67%) recommended either a healthcare sector or a payer perspective. Conclusion Researchers should justify and be transparent about their choice of perspective and costing approaches. The use of the impact inventory and reporting of disaggregate outcomes can reduce inconsistencies and confusion.

ECONOMIC SUBSTANTIATION OF TRANSITION TO PERSONNEL OUTSOURCING IN THE ORGANIZATIONS OF THE CONSTRUCTION INDUSTRY

2020 ◽  
pp. 70-79
Author(s):  
V.V. Verna
Keyword(s):  
Cost Effectiveness ◽  
Construction Industry ◽  
Methodological Approaches ◽  
Construction Organization ◽  
The Cost ◽  
The Impact

The article provides a rationale for methodological approaches to assessing the effectiveness of outsourcing in organizations of the construction industry using the example of outsourcing schemes to perform personnel functions. The conditional example shows the impact of the use of outsourcing on reducing the costs of a construction organization. The main prerequisites for the use of outsourcing in the activities of enterprises in the construction industry are identified, methodological approaches to assessing the cost-effectiveness of personnel outsourcing in the construction industry enterprises are substantiated.

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