scholarly journals Impact of Out-of-pocket Costs on Varenicline Utilization and Persistence

10.36469/9888 ◽  
2014 ◽  
Vol 2 (1) ◽  
pp. 53-62
Author(s):  
Aaron Galaznik ◽  
Katherine Cappell ◽  
Leslie Montejano ◽  
Geoffrey Makinson ◽  
Kelly H. Zou ◽  
...  
Keyword(s):  
Smoking Cessation ◽  
Linear Models ◽  
Claims Data ◽  
Reference Group ◽  
Smoking Cessation Program ◽  
Health Plans ◽  
Prior Authorization ◽  
Time To Event ◽  
Program Requirement ◽  
Out Of Pocket Costs

Background: Varenicline is a smoking cessation medication. Objectives: We analyzed patients’ out-of-pocket costs and utilization of and persistence with varenicline. Methods: De-identified claims data in the MarketScan® Commercial Claims and Encounters Database were analyzed retrospectively. Participants were all patients at least 18 years of age continuously enrolled in plans during 2009. Plans were categorized according to restriction (no coverage; prior authorization; smoking cessation program requirement; no restrictions) and out-of-pocket cost for a 30-day supply (low: <US$12; medium: US$12–24.99; high: ≥US$25). The main outcome measures were utilization (defined as presence of a drug claim) and persistence (according to days’ supply and number of days to discontinuation). Generalized linear models and time-to-event analyses were conducted. Results: There were 142,251, 458,966 and 222,241 individuals in the low, medium and high out-of-pocket cohorts, respectively. The reference group for all comparisons was the cohort with no access restrictions and low out-of-pocket costs. Higher out-of-pocket cost was associated with a lower likelihood of varenicline initiation for both the prior authorization (odds ratio [OR]=0.10, p<0.001) and smoking cessation program requirement (OR=0.19, p<0.001) groups, versus the no restriction cohort. Within the no access restriction cohort, subjects in the high out-of-pocket group were half as likely to complete a varenicline course versus the low out-of-pocket group (OR=0.47; p<0.002). Conversely, for the smoking cessation program requirement cohort, compared to the low out-of-pocket no restriction cohort, subjects who were in the high out-of-pocket group were more likely to complete a varenicline course (OR=0.70; p=0.13) than those in the low out-of-pocket group (OR=0.38; p=0.04). Conclusions: Higher varenicline out-of-pocket costs were generally associated with lower utilization of and persistence with treatment. These findings have implications for coverage policies in health plans and employers seeking to encourage smoking cessation.

scholarly journals HIGH-DEDUCTIBLE HEALTH PLANS AND COST OF HEARING AIDS AMONG ADULTS WITH HEARING LOSS: IMPLICATIONS FOR DISPARITIES

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S247-S248
Author(s):  
Elham Mahmoudi ◽  
Neil Kamdar
Keyword(s):  
Hearing Loss ◽  
Generalized Linear Models ◽  
Hearing Aids ◽  
Cost Sharing ◽  
Healthcare Costs ◽  
Linear Models ◽  
Socioeconomic Disparities ◽  
Health Plans ◽  
Total Cost ◽  
Out Of Pocket Costs

Abstract High-deductible health plans (HDHPs) have shown potential to curb rising healthcare costs. We examined use and cost of hearing aids (HAs), comparing HDHPs with non-HDHPs. Using the 2009-2016 Truven Marketscan claims, we identified adults aged 50-64 who were diagnosed with hearing loss (HL) and whether they used HAs or not (n=1,247,113). We applied multivariable generalized linear models, adjusting for age, gender, hierarchical condition categories (HCCs). To control for potential selection bias, we applied an inverse propensity score weighting. Our outcomes of interest included: (1) utilization and (2) total and out-of-pocket costs of HAs (inflation adjusted to 2016 dollars), comparing HDHPs with non-HDHPs. Number of enrollees in HDHPs increased by 343%, from 1,717 in 2009 to 7,615, in 2016. The percentage of patients who used HA increased from 9.5% (95% CI:0.09-0.10) to 15% (95% CI:0.14-0.15) within non-HDHPs and from 5% (95% CI:0.04-0.06) to 16% (95% CI:0.15-0.17) within HDHPs. The average adjusted cost sharing and total cost of HAs increased by 74% ($85 to $148) and 52% ($589 to $894), respectively, among non-HDHPs; they increased by 80% ($173 to $312) and 91% ($589 to $1,126), respectively, among HDHPs. Average out-of-pocket costs for HAs in HDHPs were twice as much as in non-HDHPs (p <0.0001). Total and out-of-pocket costs for hearing aids were substantially higher among HDHPs compared with non-HDHPs. Many employers have started offering only HDHPs, leaving their employees with no other health insurance option. Higher cost sharing may worsen the existing socioeconomic disparities in access to HAs.

A smoking cessation program for HIV-patients

Pflege ◽  
2003 ◽  
Vol 16 (5) ◽  
pp. 283-288 ◽  
Author(s):  
Jacqueline Voggensperger ◽  
Dunja Nicca ◽  
Battegay ◽  
Zellweger ◽  
Spirig
Keyword(s):  
Smoking Cessation ◽  
Smoking Cessation Program ◽  
Hiv Patients

Das Zigarettenrauchen stellt für viele Menschen ein gesundheitliches Problem mit weitreichenden Folgen dar. Da das Rauchen für Patienten und Patientinnen der HIV-Sprechstunde am Universitätsspital Basel, Schweiz, ebenfalls ein großes Problem ist, konnte ein auf Evidenz basierendes Rauchstopp-Programm entwickelt werden. Dieses Programm stützt sich auf die zwei in der Literatur beschriebenen, erfolgreichen Interventionen; die Pharmakotherapie und die Beratung. Bei der Beratung steht der Dialog mit den Betroffenen und deren Empowerment im Zentrum. Das Rauchstopp-Programm beinhaltet eine Kurzintervention, eine allgemeine Raucherberatung und eine mehrteilige Einzelberatung. Da Raucherberatungen in der Schweiz bislang beinahe ausschließlich von Ärztinnen und Ärzten durchgeführt wurden und keine deutschsprachigen Publikationen von Pflegenden in diesem Gebiet existieren, beabsichtigt dieser Artikel, Pflegenden ein Konzept zur Raucherberatung anzubieten. Unsere ersten Praxiserfahrungen zeigen, dass insbesondere die Kombination bestehend aus pflegerischer und ärztlicher Langzeitbetreuung und Nikotinsubstitution eine wirksame interdisziplinäre Intervention darstellen könnte.

Depression Scores and TNF-α in Participants of a Smoking Cessation Program

2021 ◽  
Vol 147 (2) ◽  
pp. AB82
Author(s):  
Kelsey Field ◽  
Cassandra Derella ◽  
Ryan Harris ◽  
Kathleen May ◽  
Martha Tingen
Keyword(s):  
Smoking Cessation ◽  
Smoking Cessation Program ◽  
Tnf Α

Psychological changes in successful completers of an HIV-tailored smoking cessation program: mood, attachment and self-efficacy

AIDS Care ◽  
2021 ◽  
pp. 1-9
Author(s):  
Stephanie A. Wiebe ◽  
Louise Balfour ◽  
William D. Cameron ◽  
Daniella Sandre ◽  
Crystal Holly ◽  
...  
Keyword(s):  
Smoking Cessation ◽  
Self Efficacy ◽  
Smoking Cessation Program ◽  
Psychological Changes

scholarly journals The Association of Vision, Hearing, and Dual-Sensory Loss with Walking Speed and Incident Slow Walking: Longitudinal and Time to Event Analyses in the Health and Retirement Study

2021 ◽  
Vol 42 (01) ◽  
pp. 075-084
Author(s):  
Ahmed F. Shakarchi ◽  
Lama Assi ◽  
Abhishek Gami ◽  
Christina Kohn ◽  
Joshua R. Ehrlich ◽  
...  
Keyword(s):  
Walking Speed ◽  
Linear Models ◽  
Sensory Loss ◽  
Health And Retirement Study ◽  
Time To Event ◽  
Slow Walking ◽  
Public Health Challenges ◽  
Nationally Representative ◽  
Retirement Study ◽  
Slow Walking Speed

AbstractWith the aging of the population, vision (VL), hearing (HL), and dual-sensory (DSL, concurrent VL and HL) loss will likely constitute important public health challenges. Walking speed is an indicator of functional status and is associated with mortality. Using the Health and Retirement Study, a nationally representative U.S. cohort, we analyzed the longitudinal relationship between sensory loss and walking speed. In multivariable mixed effects linear models, baseline walking speed was slower by 0.05 m/s (95% confidence interval [CI] = 0.04–0.07) for VL, 0.02 (95% CI = 0.003–0.03) for HL, and 0.07 (95% CI = 0.05–0.08) for DSL compared with those without sensory loss. Similar annual declines in walking speeds occurred in all groups. In time-to-event analyses, the risk of incident slow walking speed (walking speed < 0.6 m/s) was 43% (95% CI = 25–65%), 29% (95% CI = 13–48%), and 35% (95% CI = 13–61%) higher among those with VL, HL, and DSL respectively, relative to those without sensory loss. The risk of incident very slow walking speed (walking speed < 0.4 m/s) was significantly higher among those with HL and DSL relative to those without sensory loss, and significantly higher among those with DSL relative to those with VL or HL alone. Addressing sensory loss and teaching compensatory strategies may help mitigate the effect of sensory loss on walking speed.

The Effectiveness of a Perioperative Smoking Cessation Program

2013 ◽  
Vol 117 (3) ◽  
pp. 605-613 ◽  
Author(s):  
Susan M. Lee ◽  
Jennifer Landry ◽  
Philip M. Jones ◽  
Ozzie Buhrmann ◽  
Patricia Morley-Forster
Keyword(s):  
Smoking Cessation ◽  
Smoking Cessation Program
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