TABLE 3.
Unadjusted Study of Primary Endpoints by Pharmacy Benefit Structure (Fixed Copay or Coinsurance) in a Cohort with Type 2 Diabetes Mellitus
| Endpoint | Coinsurance (n = 6,153) | Fixed Copay (n = 30,322) | 3-Tier Fixed Copay (n = 28,228) |
|---|---|---|---|
| Persistence (days), mean (SE) | 375 (7) | 391 (3) | 388 (3) |
| Adherence, mean (SD)a | 0.75 (0.26) | 0.72 (0.25) | 0.72 (0.25) |
| Annual health care resource utilization | |||
| ≥ 1 ED visit, n (%) | 2,695 (43.8) | 12,467 (41.12) | 11,576 (41.01) |
| ≥ 1 Inpatient stay, n (%) | 1,205 (19.58) | 5,131 (16.92) | 4,730 (16.76) |
| Number of ambulatory visits, mean (SD)b | 34.54 (37.66) | 31.66 (31.59) | 31.69 (31.74) |
| Total all-cause health care cost ($), mean (SD) | 28,499 (61,322) | 28,414 (51,754) | 28,706 (52,502) |
| Medical health care cost ($), mean (SD) | 18,050 (58,019) | 17,998 (48,469) | 18,303 (49,228) |
| Inpatient | 5,749 (30,745) | 5,898 (29,800) | 6,023 (30,543) |
| Ambulatory | 10,565 (38,546) | 10,347 (25,404) | 10,484 (25,123) |
| All other medical | 1,736 (9,161) | 1,753 (8,905) | 1,796 (9,190) |
| Pharmacy health care cost ($), mean (SD) | 10,449 (12,391) | 10,416 (11,800) | 10,402 (11,829) |
aAdherence analysis was conducted among patients with ≥ 2 prescription fills and was calculated by dividing the sum of the number of days the index medication was supplied for all but the last fill in the observation period, by the number of days between the first and the last refill. The sample sizes for the adherence calculations are as follows: 5,484 (coinsurance), 27,574 (fixed copay), and 25,667 (3-tier fixed copay).
bAmbulatory is physician office and outpatient hospital encounters.
ED = emergency department; SD = standard deviation; SE = standard error.