Table 2. Frequency and Relative Risk (RR) of a Qualified Health Plan Requiring Prior Authorization for Combined Tenofovir Disoproxil Fumarate and Emtricitabine by Region and Plan Characteristics in 2019.
| Characteristic | Prior authorization, No./Total No. (%) | Crude | Adjusted | ||
|---|---|---|---|---|---|
| RR (95% CI)a | P value | RR (95% CI)b | P value | ||
| Region | |||||
| Northeast | 72/3069 (2.3) | 1 [Reference] | <.001 | 1 [Reference] | <.001 |
| West | 204/3283 (6.2) | 2.65 (2.02-3.47) | 2.36 (1.22-4.55) | ||
| Midwest | 562/4210 (13.3) | 5.69 (4.45-7.27) | 5.90 (2.99-11.63) | ||
| South | 2345/6291 (37.3) | 15.89 (12.57-20.09) | 30.74 (18.27-51.71) | ||
| Plan issuer | |||||
| National | 1220/2252 (54.2) | 3.32 (3.09-3.57) | <.001 | 3.33 (3.07-3.61) | <.001 |
| Regional | 1963/14 601 (13.4) | 1 [Reference] | 1 [Reference] | ||
| Region–high deductiblec | |||||
| Northeast | 56/2102 (2.7) | 0.91 (0.83-1.00) | <.001 | 2.73 (1.54-4.85) | <.001 |
| West | 183/2694 (6.8) | 1.91 (1.21-2.99) | 3.50 (2.18-5.61) | ||
| Midwest | 543/3857 (14.1) | 2.62 (1.66-4.13) | 2.62 (1.64-4.18) | ||
| South | 1920/5384 (35.7) | 0.76 (0.69-0.85) | 0.91 (0.76-1.08) | ||
| Cost-sharing structure | |||||
| Coinsurance | 428/5527 (7.7) | 0.33 (0.30-0.37) | <.001 | 0.51 (0.45-0.57) | <.001 |
| Copay | 2755/11 326 (24.3) | 1 [Reference] | 1 [Reference] | ||
| Drug tier | |||||
| Specialty | 196/3643 (5.4) | 0.26 (0.23-0.30) | <.001 | 0.37 (0.31-0.43) | <.001 |
| Nonspecialty | 2987/13 210 (22.6) | 1 [Reference] | 1 [Reference] | ||
| Plan level | |||||
| Platinum | 301/941 (32.0) | 2.48 (2.17-2.85) | <.001 | 2.34 (1.87-2.93) | <.001 |
| Gold | 501/3159 (15.9) | 1.21 (1.08-1.36) | 1.08 (0.95-1.23) | ||
| Silver | 1657/6808 (24.3) | 1.59 (1.45-1.73) | 0.95 (0.87-1.05) | ||
| Bronze | 692/4953 (14.0) | 1 [Reference] | 1 [Reference] | ||
| Catastrophic | 32/992 (3.2) | 0.28 (0.19-0.40) | 0.21 (0.15-0.30) | ||
| Rating area urbanicity | |||||
| Urban | 2571/12 752 (20.2) | 1.52 (1.39-1.66) | <.001 | 1.27 (1.16-1.39) | <.001 |
| Rural | 612/4101 (14.9) | 1 [Reference] | 1 [Reference] | ||
| Rating area competition, issuers per rating area | Not applicable | 1.02 (0.99-1.04) | .20 | 0.98 (0.96-1.01) | .20 |
a
Crude RRs are adjusted for region.
b
Adjusted RRs are adjusted for all factors in the table.
c
A region–high deductible variable was an interaction term used because the association between high deductible and prior authorization differed by region. For each region, the reference group is a non–high-deductible plan in that region.