Data for drugs available through low-cost prescription drug programs are available through pharmacy benefit manager and claims data

Vivienne J Zhu,Wanzhu Tu,J Marc Overhage,Anne Belsito

doi:10.1186/1472-6904-12-12

Abstract

BackgroundObservational data are increasingly being used for pharmacoepidemiological, health services and clinical effectiveness research. Since pharmacies first introduced low-cost prescription programs (LCPP), researchers have worried that data about the medications provided through these programs might not be available in observational data derived from administrative sources, such as payer claims or pharmacy benefit management (PBM) company transactions.MethodWe used data from the Indiana Network for Patient Care to estimate the proportion of patients with type 2 diabetes to whom an oral hypoglycemic agent was dispensed. Based on these estimates, we compared the proportions of patients who received medications from chains that do and do not offer an LCPP, the proportion trend over time based on claims data from a single payer, and to proportions estimated from the Medical Expenditure Panel Survey (MEPS).ResultsWe found that the proportion of patients with type 2 diabetes who received oral hypoglycemic medications did not vary based on whether the chain that dispensed the drug offered an LCPP or over time. Additionally, the rates were comparable to those estimated from MEPS.ConclusionResearchers can be reassured that data for medications available through LCPPs continue to be available through administrative data sources.

Highlights

Observational data are increasingly being used for pharmacoepidemiological, health services and clinical effectiveness research
We found that the proportion of patients with type 2 diabetes who received oral hypoglycemic medications did not vary based on whether the chain that dispensed the drug offered an low-cost prescription programs (LCPP) or over time
Researchers can be reassured that data for medications available through LCPPs continue to be available through administrative data sources

Summary

Introduction

Observational data are increasingly being used for pharmacoepidemiological, health services and clinical effectiveness research. Since pharmacies first introduced low-cost prescription programs (LCPP), researchers have worried that data about the medications provided through these programs might not be available in observational data derived from administrative sources, such as payer claims or pharmacy benefit management (PBM) company transactions. In order to determine whether LCPPs have an effect on the availability of low-cost medication dispensing data through claims, we analyzed data from a large health information exchange and compared the proportion of patients receiving each oral hypoglycemic medication available through LCPPs at pharmacy chains with and without LCPPs. We compared the proportion of patients who had at least one prescription for an oral hypoglycemic medication before and after pharmacies implemented LCPPs. Our hypothesis was that, if patients pay cash for medications available through LCPPs, the proportion of patients appearing to use these medications would appear lower for chains with LCPP compared to chains without these programs.

Methods

Results

Conclusion