Trends in Total and Out-of-pocket Payments for Noninsulin Glucose-Lowering Drugs Among U.S. Adults With Large-Employer Private Health Insurance From 2005 to 2018

Diabetes Care ◽  
2021 ◽  
pp. dc202871
Author(s):  
Hui Shao ◽  
Michael Laxy ◽  
Stephen R. Benoit ◽  
Yiling J. Cheng ◽  
Edward W. Gregg ◽  
...  
Keyword(s):  
Health Insurance ◽  
Private Health Insurance ◽  
Glucose Lowering ◽  
Out Of Pocket Payments ◽  
Large Employer

scholarly journals A Budget Impact Analysis of Substituting Sitagliptin with Liraglutide in Type 2 Diabetes from A Private Health Insurance Perspective in Egypt

2021 ◽  
Author(s):  
Gihan Hamdy El-sisi ◽  
Ayman Afify ◽  
Ashraf Abgad ◽  
Ibtissam Zakaria ◽  
Nabil Nasif ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Health Insurance ◽  
Private Health Insurance ◽  
Impact Analysis ◽  
Budget Impact ◽  
Standard Of Care ◽  
Sensitivity Analyses ◽  
Glucose Lowering ◽  
Insurance Perspective

Abstract IntroductionType 2 diabetes mellitus (T2DM) causes a sizable burden globally both from health and economic points of view.This study aimed to assess the budget impact of substituting sitagliptin with liraglutide versus other glucose lowering drugs from the private health insurance perspective in Egypt over a 3-year time horizon. MethodsTwo budget impact models were comparedthe standard of care (metformin, pioglitazone, gliclazide, insulin glargine, repaglinide, and empagliflozin)administered in addition to liraglutide or sitagliptin versus the standard of care with placebo. A gradual market introduction of liraglutide or sitagliptin was assumed, and the existing market shares for the other glucose lowering drugs were provided and validated by Expert Panel. The event rates were extracted from the LEADER and TECOS trials. Direct and mortality costs were measured. Sensitivity analyses were performed. ResultsThe estimated target population of 120,574 T2DM adult patients were associated with CV risk. The budget impact per patient per month (PPPM) for liraglutide is EGP29 ($6.7), EGP39 ($9), and EGP49 ($11.3) in the first, second, and third year, respectively. The budget impact PPPM for sitagliptin is EGP11 ($2.5), EGP14 ($3.2), and EGP18 ($4.1) in the first, second, and third year, respectively. Furthermore, adoption of liraglutide resulted in 203 fewer deaths and 550 avoided hospitalizations, while sitagliptin resulted in 43 increased deaths and 14 avoided hospitalizations. The treatment costs of liraglutide use are mostly offset by substantial savings due to fewer CV-related events, avoided mortality and avoided hospitalizations over 3-years. Conclusion Adding liraglutide resulted in a modest budget impact, suggesting that the upfront drug costs were offset by budget savings due to fewer CV-related complications and deaths avoided compared to the standard of care. While sitagliptin resulted in a small budget impact but associated with deaths increased and less hospitalizations avoided.

scholarly journals A budget impact analysis of substituting sitagliptin with liraglutide in type 2 diabetes from a private health insurance perspective in Egypt

2022 ◽  
Vol 20 (1) ◽  
Author(s):  
Gihan Hamdy Elsisi ◽  
Ayman Afify ◽  
Ashraf Abgad ◽  
Ibtissam Zakaria ◽  
Nabil Nasif ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Health Insurance ◽  
Private Health Insurance ◽  
Impact Analysis ◽  
Budget Impact ◽  
Standard Of Care ◽  
Sensitivity Analyses ◽  
Glucose Lowering ◽  
Insurance Perspective

Abstract Introduction Type 2 diabetes mellitus causes a sizable burden globally from both health and economic points of view. This study aimed to assess the budget impact of substituting sitagliptin with liraglutide versus other glucose-lowering drugs from the private health insurance perspective in Egypt over a 3-year time horizon. Methods Two budget impact models were compared with the standard of care (metformin, pioglitazone, gliclazide, insulin glargine, repaglinide, and empagliflozin) administered in addition to liraglutide or sitagliptin versus the standard of care with placebo. A gradual market introduction of liraglutide or sitagliptin was assumed, and the existing market shares for the other glucose-lowering drugs were provided and validated by the Expert Panel. The event rates were extracted from the LEADER and TECOS trials. Direct and mortality costs were measured. Sensitivity analyses were performed. Results The estimated target population of 120,574 type 2 diabetic adult patients was associated with cardio vascular risk. The budget impact per patient per month for liraglutide is EGP29 ($6.7), EGP39 ($9), and EGP49 ($11.3) in the 1st, 2nd, and 3rd years, respectively. The budget impact per patient per month for sitagliptin is EGP11 ($2.5), EGP14 ($3.2), and EGP18 ($4.1) in the 1st, 2nd, and 3rd years, respectively. Furthermore, adoption of liraglutide resulted in 203 fewer deaths and 550 avoided hospitalizations, while sitagliptin resulted in 43 increased deaths and 14 avoided hospitalizations. The treatment costs of liraglutide use are mostly offset by substantial savings due to fewer cardiovascular-related events, avoided mortality and avoided hospitalizations over 3 years. Conclusion Adding liraglutide resulted in a modest budget impact, suggesting that the upfront drug costs were offset by budget savings due to fewer cardiovascular-related complications and deaths avoided compared to the standard of care. Sitagliptin resulted in a small budget impact but was associated with increased deaths and fewer hospitalizations avoided.

Funding sources: an overview

2017 ◽  
Author(s):  
Jan Abel Olsen
Keyword(s):  
Health Insurance ◽  
Social Insurance ◽  
Private Health Insurance ◽  
Private Insurance ◽  
International Comparisons ◽  
Third Party ◽  
Alternative Funding ◽  
Funding Sources ◽  
Out Of Pocket Payments ◽  
Money Flows

This chapter provides an overview of alternative funding sources. It starts with the ‘three-party model’ to illustrate the money flows between households, providers, and purchasers, that is, government and private insurance as the third-party payers. The chapter distinguishes four funding sources which in sum will represent the total budget for possible healthcare expenditures: (1) patient payments (commonly referred to as ‘out-of-pocket’ payments); (2) private health insurance; (3) tax funding, including social insurance systems with payroll contributions; and (4) donations. These four sources of revenue can be explained by people’s preferences for their own health insurance as well as their willingness to cross-subsidize fellow citizens’ use of healthcare. International comparisons show wide disparities in the proportions of funding sources, primarily reflecting how wealthy a country is.

Constructing health consumers: Private health insurance discourses in Australia and the United Kingdom

2011 ◽  
Vol 20 (3) ◽  
pp. 306-320 ◽  
Author(s):  
Kirsten Harley ◽  
Karen Willis ◽  
Jonathan Gabe ◽  
Stephanie Doris Short ◽  
Fran Collyer ◽  
...  
Keyword(s):  
United Kingdom ◽  
Health Insurance ◽  
Private Health Insurance ◽  
The United Kingdom ◽  
Health Consumers

scholarly journals Private Health Insurance in Malaysia: Who Is Left Behind?

2021 ◽  
pp. 101053952110009
Author(s):  
Nur Zahirah Balqis-Ali ◽  
Jailani Anis-Syakira ◽  
Weng Hong Fun ◽  
Sondi Sararaks
Keyword(s):  
Health Insurance ◽  
Private Health Insurance ◽  
Home Ownership ◽  
Insurance Coverage ◽  
Binary Logistic Regression ◽  
Health Insurance Coverage ◽  
Rural Government ◽  
Lower Education Level ◽  
Current Drinker ◽  
Study Population

Despite various efforts introduced, private health insurance coverage is still low in Malaysia. The objective of this article is to find the factors associated with not having a private health insurance in Malaysia. We analyze data involving 19 959 respondents from the 2015 National Health Morbidity Survey. In this article, we describe the prevalence of not having health insurance and conducted binary logistic regression to identify determinants of uninsured status. A total of 56.6% of the study population was uninsured. After adjusting for other variables, the likelihood of being uninsured was higher among those aged 50 years and above, females, Malay/other Bumiputra ethnicities, rural, government/semigovernment, self-employed, unpaid workers and retirees, unemployed, lower education level, without home ownership and single/widowed/divorced, daily smoker, underweight body mass index, and current drinker. The likelihood of being uninsured also increased with increasing household size while the inversed trend was seen for household income. A substantial proportion of population in Malaysia did not have private health insurance, and these subgroups have limited preferential choices for provider, facility, and care.

scholarly journals Self-Rated Health Status Based on the Type of Health Insurance: A Socioeconomic Perspective

2021 ◽  
Vol 58 ◽  
pp. 004695802110281
Author(s):  
Minsung Sohn ◽  
Minsoo Jung ◽  
Mankyu Choi
Keyword(s):  
Socioeconomic Status ◽  
Health Insurance ◽  
Health Status ◽  
Regression Models ◽  
Private Health Insurance ◽  
Public And Private ◽  
Logistic Regression Models ◽  
Self Rated Health ◽  
Interaction Terms ◽  
Healthcare Coverage

To investigate the effects of public and private health insurance on self-rated health (SRH) status within the National Health Insurance (NHI) system based on socioeconomic status in South Korea. The data were obtained from 10 867 respondents of the Korea Health Panel (2008-2011). We used hierarchical panel logistic regression models to assess the SRH status. We also added the interaction terms of socioeconomic status and type of health insurance as moderators. Medical aid (MA) recipients were 2.10 times more likely to have a low SRH status than those who were covered only by the NHI, even though the healthcare utilization was higher. When the interaction terms were included, those not covered by the NHI and had completed elementary school or less were 16.59 times more likely to have a low SRH status than those covered by the NHI and had earned a college degree or higher. Expanding healthcare coverage to reduce the burden of non-payment and unmet use to improve the health status of MA beneficiaries should be considered. Particularly, the vulnerability of less-educated groups should be focused on.

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