Premium
Impact of Copayment Changes on Children's Albuterol Inhaler Use and Costs after the Clean Air Act Chlorofluorocarbon Ban
Author(s) -
Galbraith Alison A.,
Fung Vicki,
Li Lingling,
Butler Melissa G.,
Nordin James D.,
Hsu John,
Smith David,
Vollmer William M.,
Lieu Tracy A.,
Soumerai Stephen B.,
Wu Ann Chen
Publication year - 2018
Publication title -
health services research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.706
H-Index - 121
eISSN - 1475-6773
pISSN - 0017-9124
DOI - 10.1111/1475-6773.12615
Subject(s) - copayment , inhaler , pharmacy , cost sharing , asthma , medicine , chlorofluorocarbon , operations management , business , health care , family medicine , nursing , health insurance , economics , chemistry , economic growth , organic chemistry
Objective To examine changes in children's albuterol use and out‐of‐pocket ( OOP ) costs in response to increased copayments after the Food and Drug Administration banned inhalers with chlorofluorocarbon ( CFC ) propellants. Setting Four health maintenance organizations ( HMO s), two that increased copayments for albuterol inhalers that went from generic CFC ‐containing to branded CFC ‐free versions, and two that retained generic copayments for CFC ‐free inhalers (controls). We included children with asthma aged 4–17 years with commercial coverage from 2007 to 2010. Design Interrupted time series with comparison series. Data We obtained enrollee and plan characteristics from enrollment files, and utilization data from pharmacy and medical claims; OOP expenditures were extracted from pharmacy claims for two HMO s with cost data available. Findings There were no significant differences in albuterol use between the group with increased cost‐sharing and controls with respect to changes after the policy change. There was a postpolicy increase of $6.11 OOP per month per child using albuterol among those with increased cost‐sharing versus $0.36 in controls; the difference between groups was significant ( p < .01). Conclusions Increased copayments for brand‐name CFC ‐free albuterol after the CFC ban did not lead to a decrease in children's albuterol use, but it led to a modest increase in OOP costs.