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Frequency and Magnitude of Co-payments Exceeding Prescription Drug Cost

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2019, Master of Science in Pharmaceutical Science (MSP), University of Toledo, Pharmaceutical Sciences (Health Outcomes and Socioeconomic Sciences).
Objective: To investigate the healthcare expenditure in prescription drug and analyze the frequency and the magnitude of overpayments in prescription drug. Methods: Data from the 2016 Medical Expenditure Panel Survey was analyzed. Survey respondents of top ten most commonly prescribed drugs in 2016 were included in the study. Data from National Average Drug Acquisition Cost was used to identify the unit price of the prescription drugs. As NADAC changed quarterly, the average was calculated. The NDC and drug strength was used to verify the unit price with corresponding drug. The equation used to calculate estimated cash price of drug was: (Quantity dispensed x Unit Price) + Profit Margin + Dispensing Fee. Two scenarios were constructed accounting different dispensing fee – a higher and a lower. The calculated value was compared to the self OOP value reported in MEPS to determine overpaid cases. Results: With lower-end dispensing fee accounted, 29.23% of cases involved overpayment overall, with average magnitude of $8.14. With higher-end dispensing fee accounted, 6.61% of cases involved overpayment, with average magnitude of $14.59 Conclusion: Patients’ OOP cost exceed acceptable limits very frequently despite use of insurance for very commonly used generic medications. Benefit designs need to be modified and pharmacists need to look for cost saving opportunities for patients.
Varun Vaidya, PhD (Committee Chair)
Cindy Puffer, BS Pharm (Committee Member)
Megan Kaun, PharmD,RPh (Committee Member)
50 p.

Recommended Citations

Citations

  • Jeun, K. J. (2019). Frequency and Magnitude of Co-payments Exceeding Prescription Drug Cost [Master's thesis, University of Toledo]. OhioLINK Electronic Theses and Dissertations Center. http://rave.ohiolink.edu/etdc/view?acc_num=mco1564786558787039

    APA Style (7th edition)

  • Jeun, Ki Jin. Frequency and Magnitude of Co-payments Exceeding Prescription Drug Cost. 2019. University of Toledo, Master's thesis. OhioLINK Electronic Theses and Dissertations Center, http://rave.ohiolink.edu/etdc/view?acc_num=mco1564786558787039.

    MLA Style (8th edition)

  • Jeun, Ki Jin. "Frequency and Magnitude of Co-payments Exceeding Prescription Drug Cost." Master's thesis, University of Toledo, 2019. http://rave.ohiolink.edu/etdc/view?acc_num=mco1564786558787039

    Chicago Manual of Style (17th edition)