Recent Findings from Harvard University T.H. Chan School of Public Health Highlight Research in Asthma (Utilization and Spending With Preventive Drug Lists for Asthma Medications in High-Deductible Health Plans): Lung Diseases and Conditions – Asthma

2023 SEP 20 (NewsRx) -- By a News Reporter-Staff News Editor at Insurance Daily News -- Current study results on asthma have been published. According to news reporting originating from Boston, Massachusetts, by NewsRx correspondents, research stated, “Importance: High-deductible health plans with health savings accounts (HDHP-HSAs) incentivize patients to use less health care, including necessary care. Preventive drug lists (PDLs) exempt high-value medications from the deductible, reducing out-of-pocket cost sharing; the associations of PDLs with health outcomes among patients with asthma is unknown.”

The news reporters obtained a quote from the research from Harvard University T.H. Chan School of Public Health: “To evaluate the associations of a PDL for asthma medications on utilization, adverse outcomes, and patient spending for HDHP-HSA enrollees with asthma. Design, Setting, and Participants: This case-control study used matched groups of patients with asthma before and after an insurance design change using a national commercial health insurance claims data set from 2004-2017. Participants included patients aged 4 to 64 years enrolled for 1 year in an HDHP-HSA without a PDL in which asthma medications were subject to the deductible who then transitioned to an HDHP-HSA with a PDL that included asthma medications; these patients were compared with a matched weighted sample of patients with 2 years of continuous enrollment in an HDHP-HSA without a PDL. Models controlled for patient demographics and asthma severity and were stratified by neighborhood income. Analyses were conducted from October 2020 to June 2023. Exposures: Employer-mandated addition of a PDL that included asthma medications to an existing HDHP-HSA. Main Outcomes and Measures: Outcomes of interest were utilization of asthma medications on the PDL (controllers and albuterol), asthma exacerbations (oral steroid bursts and asthma-related emergency department use), and out-of-pocket spending (all and asthma-specific). A total of 12 174 participants (mean [SD] age, 36.9 [16.9] years; 6848 [56.25%] female) were included in analyses. Compared with no PDL, PDLs were associated with increased rates of 30-day fills per enrollee for any controller medication (change, 0.10 [95% CI, 0.03 to 0.17] fills per enrollee; 12.9% increase) and for combination inhaled corticosteroid long-acting b2-agonist (ICS-LABA) medications (change, 0.06 [95% CI, 0.01 to 0.10] fills per enrollee; 25.4% increase), and increased proportion of days covered with ICS-LABA (6.0% [0.7% to 11.3%] of days; 15.6% increase).”

According to the news editors, the research concluded: “Gaining a PDL was associated with decreased out-of-pocket spending on asthma care (change, -$34 [95% CI, -$47 to -$21] per enrollee; 28.4% difference), but there was no significant change in asthma exacerbations and no difference in results by income. Conclusions and Relevance: In this case-control study, reducing cost-sharing for asthma medications through a PDL was associated with increased adherence to controller medications, notably ICS-LABA medications used by patients with more severe asthma, but was not associated with improved clinical outcomes. These findings suggest that PDLs are a potential strategy to improve access and affordability of asthma care for patients in HDHP-HSAs.”

For more information on this research see: Utilization and Spending With Preventive Drug Lists for Asthma Medications in High-Deductible Health Plans. JAMA Network Open, 2023,6(8). (JAMA Network Open - https://jamanetwork.com/journals/jamanetworkopen). The publisher for JAMA Network Open is American Medical Association (AMA).

A free version of this journal article is available at https://doi.org/10.1001/jamanetworkopen.2023.31259.

Our news journalists report that more information may be obtained by contacting Anna D. Sinaiko, Department of Health Policy and Management, Harvard University T.H. Chan School of Public Health, Boston, Massachusetts, United States. Additional authors for this research include Dennis Ross-Degnan, J. Frank Wharam, Robert F. LeCates, Ann Chen Wu, Fang Zhang, Alison A. Galbraith.

(Our reports deliver fact-based news of research and discoveries from around the world.)