Table 2.
Out-of-Pocket Costs and Utilization before and after Pharmacy Benefit Change among 10,590 KPNC Patients Who Had Not Used Mail Order Pharmacy Prior to Baseline Date of Pharmacy Benefit Change (January 1, 2006)
| Pharmacy Benefit Change (before Weighting) | ||||
|---|---|---|---|---|
| Patient Characteristics | All (n = 10,590) | Yes (n = 2,442) | No (n = 8,148) | p-value for Unadjusted Difference§ |
| 12 months prior to baseline† | ||||
| Per day per medication cost,‡ for community pharmacy fills, mean (SD) | $0.17 ($0.38) | $0.23 (0.36) | $0.15 ($0.38) | <.0001 |
| Total incurred cost per refill, for community fills, mean (SD) | $9.62 ($8.53) | $13.65 ($13.04) | $8.42 ($6.11) | <.0001 |
| Days' supply dispensed, for community fills, mean (SD) | 89 (16) | 87 (18) | 89 (15) | <.0001 |
| 1-month supply dispensed | 784 (7.4) | 251 (10.3) | 533 (6.5) | <.0001 |
| 2-month supply dispensed | 347 (3.3) | 69 (2.8) | 278 (3.4) | .15 |
| 3-month supply dispensed | 9,293 (87.8) | 2,087 (85.5) | 7,206 (88.4) | <.0001 |
| Total dispensings, for community fills, mean (SD) | 14.3 (7.8) | 15.0 (7.8) | 14.1 (7.8) | <.0001 |
| Cost sharing 12 months after baseline† | ||||
| Per day per medication cost,‡ for community pharmacy fills, mean (SD) | $0.20 ($0.39) | $0.35 ($0.48) | $0.16 ($0.35) | <.0001 |
| Per day per medication cost,‡ for mail order pharmacy fills, mean (SD) | $0.18 ($0.22) | $0.28 ($0.26) | $0.09 ($0.12) | <.0001 |
| Total incurred cost per refill, for community fills, mean (SD) | $11.64 ($10.62) | $21.33 ($15.27) | $8.78 ($6.21) | <.0001 |
| Total incurred cost per refill, for mail order pharmacy fills, mean (SD) | $15.97 ($16.93) | $24.23 ($18.26) | $7.77 ($10.27) | <.0001 |
| Days supply dispensed, for | ||||
| Community pharmacy fills, mean (SD) | 88 (16) | 83 (20) | 90 (15) | <.0001 |
| Mail order pharmacy fills, mean (SD) | 91 (18) | 95 (13) | 87 (22) | <.0001 |
| 1-month supply dispensed | 801 (7.6) | 336 (13.8) | 465 (5.7) | <.0001 |
| 2-month supply dispensed | 246 (2.3) | 48 (2.0) | 198 (2.4) | .18 |
| 3-month supply dispensed | 9,417 (88.9) | 2,030 (83.1) | 7,387 (90.7) | <.0001 |
| Total dispensings, for | ||||
| Community pharmacy fills, mean (SD) | 14.7 (8.1) | 14.0 (8.8) | 14.9 (7.9) | <.0001 |
| Mail order pharmacy fills, mean (SD) | 5.6 (5.5) | 8.0 (6.3) | 3.2 (3.3) | <.0001 |
| Insurance type | ||||
| Part D group coverage (%) | 1,454 (13.7) | 22 (0.9) | 1,432 (17.6) | <.0001 |
| Part D individual coverage (%) | 1,814 (17.1) | 1,817 (74.3) | 0 | |
| Non-Medicare coverage (%) | 7,322 (69.1) | 606 (24.8) | 6,716 (82.4) | |
*
n (%) unless otherwise specified; column percentages shown.
†
2005 versus 2006 used for pre-post comparison of those not receiving the benefit.
‡
Per day medication cost equals the patient out-of-pocket cost divided by the days supply dispensed.
§
p-value for chi-square test for categorical variables and t-test for continuous variables.