1. Impact of Copayment Changes on Children's Albuterol Inhaler Use and Costs after the Clean Air Act Chlorofluorocarbon Ban.
- Author
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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., and Wu, Ann Chen
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ALBUTEROL , *INHALERS , *CHLOROFLUOROCARBON laws , *PUBLIC health , *MEDICAL care , *DRUG therapy for asthma , *INSURANCE statistics , *HEALTH maintenance organization statistics , *CHLOROFLUOROCARBONS , *COMPARATIVE studies , *HEALTH maintenance organizations , *INSURANCE , *RESEARCH methodology , *MEDICAL cooperation , *RESEARCH , *RESEARCH funding , *RESPIRATORY therapy equipment , *SOILS , *TIME series analysis , *EVALUATION research , *ECONOMICS - Abstract
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 (HMOs), 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 HMOs 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. [ABSTRACT FROM AUTHOR]- Published
- 2018
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