HMO direct costs and health care resources use after implementation of a monthly limit on sumatriptan
| Autor: | Peter E. Dans, Alice S. Sloan, Scott D. Goldfarb, Babette S. Duncan |
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| Rok vydání: | 1999 |
| Předmět: |
Male
medicine.medical_specialty Migraine Disorders Pharmacy Dihydroergotamine Drug Costs Indirect costs medicine Humans Vasoconstrictor Agents Longitudinal Studies Medical prescription health care economics and organizations Retrospective Studies Pharmacology Sumatriptan business.industry Health Policy Managed Care Programs Health Maintenance Organizations Health Care Costs medicine.disease Migraine Emergency medicine Physical therapy Managed care Female Diagnosis code business medicine.drug |
| Zdroj: | American Journal of Health-System Pharmacy. 56:2206-2210 |
| ISSN: | 1535-2900 1079-2082 |
| DOI: | 10.1093/ajhp/56.21.2206 |
| Popis: | The health care costs and resource use of patients with migraine before and after a quantity limit on sumatriptan was introduced in an HMO were compared. A longitudinal, retrospective review of a medical claims database and a pharmacy claims database was conducted for two six-month periods before and after a monthly limit (four tablets or injections) on sumatriptan reimbursement was instituted at an independent practice association-model HMO in February 1997. Patients with at least one medical claim with a diagnosis code for migraine or at least two pharmacy claims for sumatriptan, methysergide, ergotamine, dihydroergotamine, or an ergotamine combination product in 1996 or 1997 were eligible for inclusion. A total of 557 patients were included in the analysis. Migraine-related medical costs and total medical costs increased 1.5% and 24.4%, respectively; neither change was statistically significant. Physician office visits related to migraine increased by 7.8%. The number of hospital admissions for the cohort increased from three to five, but hospital costs decreased by 55.0%. The overall costs of medications for migraine therapy decreased by 4.5%. There was an 8.2% increase in prescriptions for drugs to treat migraine but a 40.0% decrease in their cost, primarily because of decreased sumatriptan use. There was a 33.9% increase in prescriptions for medications that could be used as prophylaxis for migraine and a 49.6% increase in their cost. Implementation of a monthly limit on sumatriptan decreased an HMO's pharmacy costs but did not significantly alter migraine-related direct medical costs and health care resource use of patients with migraine. |
| Databáze: | OpenAIRE |
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