TY - JOUR
T1 - Out-of-pocket and total costs of fixed-dose combination antihypertensives and their components
AU - Rabbani, Atonu
AU - Alexander, G. Caleb
N1 - Funding Information:
We used the 2004 Medical Expenditure Panel Survey to analyze and compare the relative costs of combination drugs and their individual components. The survey, funded by the Agency of Healthcare Research and Quality, uses a longitudinal panel design and a national probability sample of the noninstitutionalized population to examine individuals’ health-care utilization and expenditures. Here, we focus on the household component of the survey that includes information on prescribed medicines. Data on each prescription medicine purchased by a survey participant is derived from self-report and supplemented with analyses of pharmacy and medical records. These records include receipts, bills, and other documentation of payments for a given individuals’ medical care (e.g., prescription drugs), including out-of-pocket disbursements and payments made by other sources such as Medicare, Medicaid, or private insurers.
Funding Information:
Disclosure: Dr. alexander has received grant funding from Merck and Pfizer.
PY - 2008/5
Y1 - 2008/5
N2 - Background: Many patients are burdened by prescription costs, yet it is not clear whether brand-named fixed-dose combination medicines are less expensive than the sum of the cost of their generic components. Methods: We used the Medical Expenditure Panel Survey, a rigorously conducted, nationally representative, population-based survey, to examine the out-of-pocket and third party costs associated with the most commonly prescribed, brand-named fixed-dose combination antihypertensive drugs. We compared the out-of-pocket and third party cost for a 30-day supply of each of these combination drugs with the sum of these costs for their individual generic components. Results: Twenty-seven combination antihypertensive medicines were examined. Overall, combination products had higher out-of-pocket costs and lower total costs than did the sum of the costs of their components. For example, the out-of-pocket costs were greater for 24 of 27 combination drugs examined, and the mean increase in monthly out-of-pocket costs associated with combination therapy was $13.38 (95% confidence interval, $12.27-14.50). In contrast, the total cost was lower for 23 of the 27 combination drugs examined, and the mean decrease in monthly total costs was $20.89 (95% confidence interval, $20.10-21.68). Conclusions: Given patient burden and nonadherence from out-of-pocket prescription costs, the clinical benefits of brand-named fixed-dose combination antihypertensive therapy should be balanced with their greater out-of-pocket costs.
AB - Background: Many patients are burdened by prescription costs, yet it is not clear whether brand-named fixed-dose combination medicines are less expensive than the sum of the cost of their generic components. Methods: We used the Medical Expenditure Panel Survey, a rigorously conducted, nationally representative, population-based survey, to examine the out-of-pocket and third party costs associated with the most commonly prescribed, brand-named fixed-dose combination antihypertensive drugs. We compared the out-of-pocket and third party cost for a 30-day supply of each of these combination drugs with the sum of these costs for their individual generic components. Results: Twenty-seven combination antihypertensive medicines were examined. Overall, combination products had higher out-of-pocket costs and lower total costs than did the sum of the costs of their components. For example, the out-of-pocket costs were greater for 24 of 27 combination drugs examined, and the mean increase in monthly out-of-pocket costs associated with combination therapy was $13.38 (95% confidence interval, $12.27-14.50). In contrast, the total cost was lower for 23 of the 27 combination drugs examined, and the mean decrease in monthly total costs was $20.89 (95% confidence interval, $20.10-21.68). Conclusions: Given patient burden and nonadherence from out-of-pocket prescription costs, the clinical benefits of brand-named fixed-dose combination antihypertensive therapy should be balanced with their greater out-of-pocket costs.
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U2 - 10.1038/ajh.2008.31
DO - 10.1038/ajh.2008.31
M3 - Article
C2 - 18437141
AN - SCOPUS:42549137097
VL - 21
SP - 509
EP - 513
JO - American journal of hypertension
JF - American journal of hypertension
SN - 0895-7061
IS - 5
ER -