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Biomedical subjects

Cindy Parks Thomas

Publications and source records attributed to Cindy Parks Thomas.

7 recordsLinked to original sources
PubMed2007

Differences in prescription drug use in HMO and self-insured health plans.

Using pharmacy benefits manager claims data, this study analyzed how cost-management techniques including cost sharing affected enrollees in health maintenance organizations (HMOs) versus employer-sponsored fee-for-service plans. Because HMOs bear the risk of pharmaceutical costs and influence the prescribing practices of the physicians in their network, we expected different patterns of prescription use, such as proportionately more generic medications in HMOs. Also, because HMO physicians are likely to prescribe relatively more drugs for high-severity conditions, HMO enrollee demand should be less price sensitive. The impact of cost sharing was found to be significantly less for HMOs. A 5-dollar increase in copayments decreased expenditures by 16 percent in fee-for-service plans but only by 1 percent in HMOs. Furthermore, when cost sharing was set at zero, HMO plans were found to have significantly fewer and cheaper medications, resulting in lower per-enrollee medication expenditures.

Drug Prescriptions↗
PubMed2006

Trends in the use of psychotropic medications among adolescents, 1994 to 2001.

OBJECTIVES: Few psychotropic medications are approved for use among children younger than 18 years. Yet previous studies have shown an increase in the use of psychotropic medications among school-age children and adolescents. Most previous studies examined data only up to 1997; therefore, the results predate any impact of changing federal policies and newly marketed medications. This study examined trends in the prescription of psychotropic medications to adolescents aged 14 to 18 years in office-based care in the United States from 1994 to 2001. METHODS: Data from the National Ambulatory Medical Care Survey (NAMCS) were used to determine visit rates and prescribing patterns from 1994 to 2001 for psychotropics that were prescribed in office-based treatment settings to adolescents aged 14 to 18 years. Rates of visits that resulted in a prescription for psychotropic medication were calculated for two-year periods. Analyses were conducted by type of medication, gender, and the prescribing physician's specialty. RESULTS: Rates of visits that resulted in a psychotropic prescription increased from 3.4 percent in 1994-1995 to 8.3 percent in 2000-2001. These trends were evident for males and females. The average annual growth rates for psychotropic prescriptions were much higher after 1999. Trends were also significant across drug classes. By 2001, one out of ten office visits by adolescent males resulted in a prescription for a psychotropic medication. CONCLUSIONS: Average annual growth rates for the prescription of psychotropics to adolescents increased from 1994 to 2001, with especially rapid acceleration after 1999. This increase may be associated with changing thresholds of diagnosis and treatment, availability of new medications, and changes in federal regulatory policies concerning promotion of medications by the pharmaceutical industry.

Adolescent↗
PubMed2003

Research to practice: adoption of naltrexone in alcoholism treatment.

Naltrexone, a prescription medication, was approved in December 1994 as an adjunct to counseling in treatment of alcoholism and alcohol abuse, representing the first new medication for alcoholism in several decades. Initial controlled trials indicated that it is effective in preventing relapse, while later trials show mixed results. Although many physicians and others treating alcoholism have found naltrexone to be very helpful in treatment, it is still a technology that has not been used widely. In this study, we examine which clinicians have adopted naltrexone into practice for what reasons, and what clinical and nonclinical factors acted as barriers to its use. In our mail survey of alcoholism treatment clinicians, 80% of physicians and 45% of nonphysicians report prescribing or recommending naltrexone at least rarely, but only 15% of physicians, even among addiction specialists, prescribe naltrexone often. The strongest barriers to adoption of naltrexone were financing and inadequate knowledge about the medication, followed by lack of sufficient evidence regarding effectiveness. Clinicians were most likely to adopt naltrexone if they were affiliated with treatment programs that actively promoted its use. We conclude that in order for a new substance abuse treatment medication to be widely adopted in clinical practice, information about it must be properly directed, clinicians must be convinced of its effectiveness, it must be adequately financed, and the treatment organizations in which clinicians work must promote its use.

Alcoholism↗
PubMedDate not supplied

Health plans' strategies to control prescription drug spending.

A number of recent studies have documented the sizable impact of consumer cost sharing without accounting for the other drug management strategies being adopted simultaneously. This qualitative case study of five of California's largest health plans examines the strategies and methods used to control prescription drug use and spending. Higher cost sharing is being used increasingly. Concurrently, major administrative efforts directed at physicians-including rules, incentives, and education-are being undertaken. These efforts have focused on lowering the cost per prescription by emphasizing generic substitution and therapeutic interchange of less costly drugs.

California↗
PubMedDate not supplied

Impact of health plan design and management on retirees' prescription drug use and spending, 2001.

We examined 2001 prescription drug claims for a range of employer-based retiree plans administered by a national pharmacy benefit management firm, to understand how use and spending differ with various cost-sharing approaches and other drug use management techniques among the elderly. In these plans, most of which had generous benefits and substantial use of mail order, more aggressive cost-sharing requirements combined with other management strategies were associated with greater member cost sharing, a shift to less costly medications (generic and mail order), and lower total prescription drug spending. Although we did not find lower rates of use in plans with aggressive cost sharing, this may be attributable in part to their higher drug use associated with mail-order incentives.

Aged↗
PubMedDate not supplied

How do seniors use their prescription drug discount cards?

This study examines how seniors enrolled in a major national prescription drug discount program used their cards in the year before the Medicare discount card program's implementation, to establish baseline information. Seniors who actively enrolled relied heavily on the card for their purchases. They saved 20 percent overall but still spent more than dollar 1,300 annually on prescriptions, on average. Fewer than half of those who were automatically enrolled as a free Medigap benefit used the card. This suggests that some had other options or that more effort is needed to assure that seniors understand the value of drug savings programs and how to use them.

Aged↗