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High‐Cost Users of Prescription Drugs: A Population‐Based Analysis from British Columbia, Canada

Health services research, 2017-04, Vol.52 (2), p.697-719 [Peer Reviewed Journal]

2016 The Authors. published by Wiley Periodicals, Inc. on behalf of Health Research and Educational Trust ;2016 The Authors. Health Services Research published by Wiley Periodicals, Inc. on behalf of Health Research and Educational Trust. ;COPYRIGHT 2017 Health Research and Educational Trust ;COPYRIGHT 2017 Health Research and Educational Trust ;Health Research and Educational Trust ;ISSN: 0017-9124 ;EISSN: 1475-6773 ;DOI: 10.1111/1475-6773.12492 ;PMID: 27087391 ;CODEN: HESEA5

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Title:
High‐Cost Users of Prescription Drugs: A Population‐Based Analysis from British Columbia, Canada
Author: Weymann, Deirdre ; Smolina, Kate ; Gladstone, Emilie J. ; Morgan, Steven G.
Subjects: Accounting ; Adolescent ; Adult ; Age Factors ; Aged ; Aged, 80 and over ; Ambulatory Care - economics ; Ambulatory Care - statistics & numerical data ; Analysis ; Antineoplastic Agents - economics ; Antineoplastic Agents - therapeutic use ; British Columbia ; Cancer ; Child ; Child, Preschool ; Chronic Disease - drug therapy ; Cluster analysis ; Clustering ; Cost analysis ; Costs ; Costs and Expenditures ; Delivery of Health Care - utilization ; Drug abuse ; Drug Costs - statistics & numerical data ; Drug development ; Drug industry ; Drugs ; Economic aspects ; Expenditures ; Health care costs ; Health care expenditures ; Health services ; Heterogeneity ; high‐cost users ; Hospitals ; Hospitals - utilization ; Humans ; Infant ; Infant, Newborn ; Male ; Medical care, Cost of ; Middle Aged ; Mortality ; Pharmaceutical policy ; Pharmaceuticals ; population‐based analysis ; Prescribing ; Prescription drug costs ; Prescription drugs ; Prescription Drugs - economics ; Prescription Drugs - therapeutic use ; Prescriptions (Drugs) ; Sex Factors ; Sociodemographics ; Studies ; User group ; User groups ; Young Adult
Is Part Of: Health services research, 2017-04, Vol.52 (2), p.697-719
Description: Objective To examine variation in pharmaceutical spending and patient characteristics across prescription drug user groups. Data Sources British Columbia's population‐based linked administrative health and sociodemographic databases (N = 3,460,763). Study Design We classified individuals into empirically derived prescription drug user groups based on pharmaceutical spending patterns outside hospitals from 2007 to 2011. We examined variation in patient characteristics, mortality, and health services usage and applied hierarchical clustering to determine patterns of concurrent drug use identifying high‐cost patients. Principal Findings Approximately 1 in 20 British Columbians had persistently high prescription costs for 5 consecutive years, accounting for 42 percent of 2011 province‐wide pharmaceutical spending. Less than 1 percent of the population experienced discrete episodes of high prescription costs; an additional 2.8 percent transitioned to or from high‐cost episodes of unknown duration. Persistent high‐cost users were more likely to concurrently use multiple chronic medications; episodic and transitory users spent more on specialized medicines, including outpatient cancer drugs. Cluster analyses revealed heterogeneity in concurrent medicine use within high‐cost groups. Conclusions Whether low, moderate, or high, costs of prescription drugs for most individuals are persistent over time. Policies controlling high‐cost use should focus on reducing polypharmacy and encouraging price competition in drug classes used by ordinary and high‐cost users alike.
Publisher: United States: Health Research and Educational Trust
Language: English
Identifier: ISSN: 0017-9124
EISSN: 1475-6773
DOI: 10.1111/1475-6773.12492
PMID: 27087391
CODEN: HESEA5
Source: Geneva Foundation Free Medical Journals at publisher websites
MEDLINE
PubMed Central

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High‐Cost Users of Prescription Drugs: A Population‐Based Analysis from British Columbia, Canada

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