Impact of Increased Copayments on the Discontinuation/Switching Rates of Nonformulary Medications

2005 ◽  
Vol 21 (3) ◽  
pp. 137-143 ◽  
Author(s):  
Kavita V Nair ◽  
Robert J Valuck ◽  
Richard R Allen ◽  
Sonya J Lewis
Keyword(s):  
Chronic Diseases ◽  
Inappropriate Medication ◽  
Clear Relationship ◽  
Percentage Increase ◽  
Pharmacy Benefit ◽  
Western Us ◽  
Current Medication ◽  
Before And After ◽  
The Impact ◽  
Continuation Rates

Background: Patients with chronic diseases are particularly affected by prescription copayment increases, as they are faced with the decision to switch to formulary alternatives or pay more to stay on their current medication. Objective: To evaluate the impact of increased copayments as a result of a change in formulary status on the continuation rates of nonformulary medications in multitiered pharmacy benefit plans. Methods: A retrospective cohort study was conducted on patients with chronic diseases who were part of a health plan in the western US. Individuals were selected if they were taking a medication that was being removed from the health plan's formulary and, thus, experienced increases in their copayments for nonformulary medications (n = 1,244). The time periods before and after the increase in copayments were studied. Adjusting for demographics, chronic comorbidities, medication use, Medicare + Choice status, and percentage increase in copayment for nonformulary medications, Cox regressions were used to assess continuation rates for these drugs. Results: A clear relationship between increasing copayment differentials and continuation rates for nonformulary medications in the period after the copayment increases could not be established. In general, those who experienced higher copayment differentials (50–100%, 100–200%, >200%) were more likely to continue their nonformulary medication than were those who experienced copayment increases of 25–50% and >25%. Conclusions: Individuals confronted with increased copayments often switched their drugs to formulary alternatives. However, a clear relationship could not be established between increasing copayments and continuation behavior. Further research is needed to determine whether these switching behaviors result in inappropriate medication behaviors, such as complete discontinuation of drug therapy due to the increased costs.

scholarly journals The impact of number of drugs prescribed on the risk of potentially inappropriate medication among outpatient older adults with chronic diseases

QJM ◽  
2013 ◽  
Vol 106 (11) ◽  
pp. 1009-1015 ◽  
Author(s):  
M.-C. Weng ◽  
C.-F. Tsai ◽  
K.-L. Sheu ◽  
Y.-T. Lee ◽  
H.-C. Lee ◽  
...  
Keyword(s):  
Older Adults ◽  
Chronic Diseases ◽  
Inappropriate Medication ◽  
Potentially Inappropriate Medication ◽  
The Impact

scholarly journals Pendidikan Pengelolaan Sampah Menggunakan Konsep 6M untuk Masyarakat Sumbawa

2020 ◽  
Author(s):  
Supratman
Keyword(s):  
Waste Management ◽  
Public Perception ◽  
Public Understanding ◽  
Household Waste ◽  
Environmental Damage ◽  
Percentage Increase ◽  
Formal Sector ◽  
The Public ◽  
Before And After ◽  
The Impact

This study aims to determine the education of process waste 6M concept can provide insight to the public about waste management Households in the district of Sumbawa, To find an application that can be related to the management of household waste with 6M concepts, and to determine the impact that occurs when the public understanding of garbage is still minimal as trigger environmental damage. The model used in this research is quantitative descriptive provide socialization of 6M concept by testing the understanding and action keteramplan before and after the action and FGD (Focus Group Descution), bringing together the public perception of waste management with the concept 6M. This model is made for the purpose of data collection and verification of data. The design of this study using the technique of pretest-posttest or before and after the action and FGD. in the process of collecting information as described in the flow chart descriptive research with quantitative approach on the management of household waste. This study aims to gain a real picture of the waste processing education using 6M concept to the public in Sumbawa regency. The results of the analysis of citizen understanding keluarahan Seeds goods Sumbawa before action is 57.61 while after action increased by 81.90 percentage increase is 81.65%. In the harbor village of Sumbawa District of Labuhan Badas average value before the action of 50.47 and after the action of 80.95 percentage increase of 29.9%. The results of the community skills in waste management in urban village concept Brang 6M Seeds value after the action of 81.19 while the village harbor Sumbawa after the action of 78.57 with a high category. The similarity of the public perception of waste management can be described as follows. that overall participants socialization has been followed properly. waste management education research with 6M concepts tested on non-formal sector is the mother-housewife RT, RW, Village Badas Badas Labuahan District of Sumbawa Besar and mother-housewife RT, RW keluarahan Seeds Brang Sumbawa District of Sumbawa, provide good autput in upayameningkatkan community understanding and skills in the management of household waste.

scholarly journals The intervention of Rural Enterprise Development Hub Project on Maize Production in Mqanduli: The Implication on Food Security Status of Maize Farmers

2019 ◽  
Vol 51 (2) ◽  
pp. 165
Author(s):  
Enoch Terlumun Iortyom ◽  
Sonwabo P. Mazinyo ◽  
Werner Nel
Keyword(s):  
Food Security ◽  
P Value ◽  
Percentage Increase ◽  
Enterprise Development ◽  
Maize Production ◽  
Food Security Status ◽  
Before And After ◽  
Nutritional Needs ◽  
The Impact ◽  
Project Intervention

The research analyzed the impact of the Rural Enterprise Development Hub Project (RED Hub Project) on food security of maize farmers. The data were analyzed using both inferential and descriptive statistics. Values were considered to be significant statistically where the P-value was less than 0.05. The study reveals a significant average increase in annual yield from 39.52 bags (50kg) to 87.02 bags (50kg) with a percentage increase of 120.19% per maize farm (t-statistics of 32.7 t-value and p-value of <0.05). Also, none of the maize farmers were food secure before the RED Hub project, 1 (0.5%) were mildly food insecure, 97 (48.5%) were averagely food insecure, and 102 (51%) were critically food insecure. After the RED Hub project intervention, 3.5% (7) are food secure, 104 (52%) are mildly food insecure, 76 (38%) are averagely food insecure and 13 (6.5%) critically food insecure. There was also more access and affordability of other food to meet maize farmers’ nutritional needs after the project intervention. An average of 72.5 (29.2%) beneficiaries and 99.3 (47.6%) beneficiaries respectively had access to other foods to meet their nutritional needs before and after the project intervention.

scholarly journals Pendidikan Pengelolaan Sampah Menggunakan Konsep 6M untuk Masyarakat Sumbawa

2020 ◽  
Author(s):  
Supratman
Keyword(s):  
Waste Management ◽  
Public Perception ◽  
Public Understanding ◽  
Household Waste ◽  
Environmental Damage ◽  
Percentage Increase ◽  
Formal Sector ◽  
The Public ◽  
Before And After ◽  
The Impact

This study aims to determine the education of process waste 6M concept can provide insight to the public about waste management Households in the district of Sumbawa, To find an application that can be related to the management of household waste with 6M concepts, and to determine the impact that occurs when the public understanding of garbage is still minimal as trigger environmental damage. The model used in this research is quantitative descriptive provide socialization of 6M concept by testing the understanding and action keteramplan before and after the action and FGD (Focus Group Descution), bringing together the public perception of waste management with the concept 6M. This model is made for the purpose of data collection and verification of data. The design of this study using the technique of pretest-posttest or before and after the action and FGD. in the process of collecting information as described in the flow chart descriptive research with quantitative approach on the management of household waste. This study aims to gain a real picture of the waste processing education using 6M concept to the public in Sumbawa regency. The results of the analysis of citizen understanding keluarahan Seeds goods Sumbawa before action is 57.61 while after action increased by 81.90 percentage increase is 81.65%. In the harbor village of Sumbawa District of Labuhan Badas average value before the action of 50.47 and after the action of 80.95 percentage increase of 29.9%. The results of the community skills in waste management in urban village concept Brang 6M Seeds value after the action of 81.19 while the village harbor Sumbawa after the action of 78.57 with a high category. The similarity of the public perception of waste management can be described as follows. that overall participants socialization has been followed properly. Waste management education research with 6M concepts tested on non-formal sector is the mother-housewife RT, RW, Village Badas Badas Labuahan District of Sumbawa Besar and mother-housewife RT, RW keluarahan Seeds Brang Sumbawa District of Sumbawa, provide good autput in upayameningkatkan community understanding and skills in the management of household waste.

Strategic Role of Zakat in Multidimensional Quality of Life in Sijunjung, Indonesia

2018 ◽  
Vol 15 (1) ◽  
pp. 55-72
Author(s):  
Herlin Hamimi ◽  
Abdul Ghafar Ismail ◽  
Muhammad Hasbi Zaenal
Keyword(s):  
Quality Of Life ◽  
Positive Impact ◽  
Wealth Distribution ◽  
Absolute Poverty ◽  
Before And After ◽  
The Status ◽  
Being There ◽  
The Impact

Zakat is one of the five pillars of Islam which has a function of faith, social and economic functions. Muslims who can pay zakat are required to give at least 2.5 per cent of their wealth. The problem of poverty prevalent in disadvantaged regions because of the difficulty of access to information and communication led to a gap that is so high in wealth and resources. The instrument of zakat provides a paradigm in the achievement of equitable wealth distribution and healthy circulation. Zakat potentially offers a better life and improves the quality of human being. There is a human quality improvement not only in economic terms but also in spiritual terms such as improving religiousity. This study aims to examine the role of zakat to alleviate humanitarian issues in disadvantaged regions such as Sijunjung, one of zakat beneficiaries and impoverished areas in Indonesia. The researcher attempted a Cibest method to capture the impact of zakat beneficiaries before and after becoming a member of Zakat Community Development (ZCD) Program in material and spiritual value. The overall analysis shows that zakat has a positive impact on disadvantaged regions development and enhance the quality of life of the community. There is an improvement in the average of mustahik household incomes after becoming a member of ZCD Program. Cibest model demonstrates that material, spiritual, and absolute poverty index decreased by 10, 5, and 6 per cent. Meanwhile, the welfare index is increased by 21 per cent. These findings have significant implications for developing the quality of life in disadvantaged regions in Sijunjung. Therefore, zakat is one of the instruments to change the status of disadvantaged areas to be equivalent to other areas.

ANALISIS PENGARUH PEMBANGUNAN JALAN LAYANG JANTI TERHADAP PERKEMBANGAN TATA RUANG KAWASAN JANTI STUDI KASUS : KAWASAN JANTI, DESA CATURTUNGGAL, KABUPATEN SLEMAN, D. I. YOGYAKARTA

2017 ◽  
Vol 11 (3) ◽  
pp. 255
Author(s):  
Jeky El Boru
Keyword(s):  
Road Network ◽  
Open Space ◽  
Qualitative Description ◽  
Analysis Method ◽  
Open Spaces ◽  
The Road ◽  
Before And After ◽  
Linkage Method ◽  
The Impact ◽  
Parking Place

Abstract: This research aims to analyze the impact of Janti Flyover Construction toward the growth of layout at Janti Urban Area, including structured space, open space, and linkage. Method used for data collecting are observation, air photograph monitoring, and interview, whereas the analysis method is qualitative description, which is the superimposed method of two layers, that are the layout condition before and after flyover construction. The result shows that the impact of Janti Flyover construction can be seen on building mass (solid), the increasing number of open spaces, including the road network, parking place, and park, whereas the relation between spaces, visually and structurally, can be seen on the growth of buildings which have new shapes and styles, therefore the performance of the overall building does not have a proportional shape. Considering Janti Street at the collective relation, its role is getting stronger as the main frame road network.Keywords: Flyover construction, layout changing, Janti AreaAbstrak: Penelitian ini bertujuan untuk menganalisis pengaruh pembangunan Jalan Layang Janti terhadap perkembangan tata ruang Kawasan Janti, meliputi ruang terbangun, ruang terbuka, serta hubungan antar ruang (“linkage”). Metode pengumpulan data dilakukan melalui observasi, pengamatan foto udara, dan wawancara; sedangkan metode analisis melalui deskripsi secara kualitatif yang berupa “superimposed method” dari dua lapisan kondisi lahan, yakni kondisi tata ruang sebelum dan sesudah pembangunan jalan layang. Hasil penelitian menunjukkan bahwa pengaruh pembangunan Jalan Layang Janti terdapat pada massa bangunan (“solid”), pertambahan ruang terbuka yang berupa jaringan jalan, parkir, dan taman; sedangkan pada hubungan antar ruang ̶ secara visual dan struktural ̶ yakni tumbuhnya bangunan dengan bentuk dan gaya baru, sehingga bentuk tampilan bangunan secara keseluruhan tidak proporsional. Pada hubungan kolektif, Jalan Janti semakin kuat perannya sebagai kerangka utama jaringan jalan.Kata kunci : Pembangunan jalan layang, tata ruang, Kawasan Janti

Impact of merger on efficiency and productivity : a case study of commercial banks in Malaysia

1970 ◽  
Vol 5 (1) ◽  
pp. 77
Author(s):  
Mahadzir Ismail ◽  
Saliza Sulaiman ◽  
Hasni Abdul Rahim ◽  
Nordiana Nordin
Keyword(s):  
Efficiency Score ◽  
Malmquist Productivity Index ◽  
Productivity Index ◽  
Data Envelopment ◽  
Master Plan ◽  
Before And After ◽  
Domestic Banks ◽  
The Impact ◽  
Efficiency And Productivity

The Financial Master Plan (2001- 2010) aims to enhance the capacity of banking industry so that higher effic iency and productivity can be reaped in the future. This study seeks to determine the impact of merger on the efficiency and productivity ofcommercial banks in Malaysia for the period 1995 until 2005. The study uses a non-parametric approach, nam ely DEA (data envelopment analysis?) to estimate the efficiency scores and to construct the Malmquist productivity index. To enable this estimation, three bank inputs and outputs are used. Amongst the findings are those banks exhibit higher efficiency score after the merger and thefo reign banks are more efficient than the local banks. Productivity of the banks is calculated in both periods, before and after the merger: The results show that, it is the local banks that have improved the most after the merger. The main source of productivity is technical change or innovation. The findings support the existing policy of having larger domestic banks in term of size.

THE EFFECT OF METACOGNITIVE INSTRUCTION ON MAXIMIZING EFL LEARNERS’ METACOGNITIVE AWARENESS IN LISTENING

2018 ◽  
Vol 7 (1) ◽  
pp. 8-17
Author(s):  
Mahsa Assadi
Keyword(s):  
Experimental Research ◽  
Listening Comprehension ◽  
Intervention Program ◽  
Metacognitive Awareness ◽  
Listening Test ◽  
Efl Learners ◽  
Metacognitive Instruction ◽  
Before And After ◽  
Comprehension Ability ◽  
The Impact

This study reports a pre-experimental research on the impact of metacognitive instruction on EFL learners’ metacognitive awareness and their listening performance. To obtain the goal of the study, a group of 30 Iranian intermediate EFL learners, including 14 males and 16 females, were selected randomly. Their ages range from 20 to 24. The participants took part in 16 weeks’ intervention program based on metacognitive pedagogical sequence consisted of five stages. The metacognitive awareness listening questionnaire (MALQ), and a listening test were also used to find changes in metacognitive awareness and listening performance before and after the treatment. The results of comparing pre and posttests scores revealed that metacognitive instruction raised the learners’ metacognitive awareness and helped them improve their listening comprehension ability.

Impact of Michigan’s new opioid prescribing laws on spine surgery patients: analysis of the Michigan Spine Surgery Improvement Collaborative

2020 ◽  
pp. 1-6
Author(s):  
Paul Park ◽  
Victor Chang ◽  
Hsueh-Han Yeh ◽  
Jason M. Schwalb ◽  
David R. Nerenz ◽  
...  
Keyword(s):  
Spine Surgery ◽  
Spinal Surgery ◽  
Readmission Rate ◽  
Rating Scale ◽  
Short Term ◽  
Readmission Rates ◽  
Opioid Prescribing ◽  
Number Of Patients ◽  
Before And After ◽  
The Impact

OBJECTIVEIn 2017, Michigan passed new legislation designed to reduce opioid abuse. This study evaluated the impact of these new restrictive laws on preoperative narcotic use, short-term outcomes, and readmission rates after spinal surgery.METHODSPatient data from 1 year before and 1 year after initiation of the new opioid laws (beginning July 1, 2018) were queried from the Michigan Spine Surgery Improvement Collaborative database. Before and after implementation of the major elements of the new laws, 12,325 and 11,988 patients, respectively, were treated.RESULTSPatients before and after passage of the opioid laws had generally similar demographic and surgical characteristics. Notably, after passage of the opioid laws, the number of patients taking daily narcotics preoperatively decreased from 3783 (48.7%) to 2698 (39.7%; p < 0.0001). Three months postoperatively, there were no differences in minimum clinically important difference (56.0% vs 58.0%, p = 0.1068), numeric rating scale (NRS) score of back pain (3.5 vs 3.4, p = 0.1156), NRS score of leg pain (2.7 vs 2.7, p = 0.3595), satisfaction (84.4% vs 84.7%, p = 0.6852), or 90-day readmission rate (5.8% vs 6.2%, p = 0.3202) between groups. Although there was no difference in readmission rates, pain as a reason for readmission was marginally more common (0.86% vs 1.22%, p = 0.0323).CONCLUSIONSThere was a meaningful decrease in preoperative narcotic use, but notably there was no apparent negative impact on postoperative recovery, patient satisfaction, or short-term outcomes after spinal surgery despite more restrictive opioid prescribing. Although the readmission rate did not significantly increase, pain as a reason for readmission was marginally more frequently observed.

Sign in / Sign up

Export Citation Format

Share Document