Insurance Choice and Benefit Design
Our work in Insurance Choice and Benefit Design
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A Cost-Benefit Analysis of Using Evidence of Effectiveness in Terms of Progression Free Survival in Making Reimbursement Decisions on New Cancer Therapies
This study developed a general cost-benefit framework that quantified the competing tradeoffs of the use of progression-free survival versus that of overall survival effects in oncology reimbursement.
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The Association Between Employee Obesity and Employer Costs: Evidence from a Panel of US Employers
This study estimated employer costs associated with employee obesity and found that obesity is associated with large employer costs from direct health care and insurance claims and indirect costs from lost productivity owing to workdays lost because of illness and disability.
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Formulary Restrictions on Atypical Antipsychotics: Impact on Costs for Patients with Schizophrenia and Bipolar Disorder in Medicaid
This study found that applying formulary restrictions to atypical antipsychotics is associated with higher total medical expenditures for patients with schizophrenia and bipolar disorder in Medicaid, and that, combined with the other social costs such as an increase in incarceration rates, these formulary restrictions could increase state costs by $1 billion annually, enough to offset any savings in pharmacy costs.
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Do Strict Formularies Replicate Failure for Patients with Schizophrenia?
This study measured the impact of Medicaid formulary restrictions (FRs) on the rate at which patients who previously failed a drug therapy for schizophrenia are returned to that therapy and found that, regardless of FRs, patients tend to resume the same drug after an adverse medical event.
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Opioid Prescribing by Multiple Providers in Medicare: Retrospective Observational Study of Insurance Claims
This study found that concurrent opioid prescribing by multiple providers is common in Medicare patients and is associated with higher rates of hospital admission related to opioid use.
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Digesting the Doughnut Hole
Joyce, Zissimopoulos, and Goldman compare the use of prescription drugs among beneficiaries subject to the coverage gap (also known as the doughnut hole) with usage among beneficiaries who are not exposed to it.
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Innovation in Cancer Care: Value, Costs and Quality
When considering whether high-cost treatments for cancer and other serious diseases are worth the price, value should be defined from the patient’s viewpoint.
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