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CONTEXT Many health plans have instituted more cost sharing to discourage use of more expensive pharmaceuticals and to reduce drug spending. OBJECTIVE To determine how changes in cost sharing affect use of the most commonly used drug classes among the privately insured and the chronically ill. DESIGN, SETTING, AND PARTICIPANTS Retrospective US study(More)
PURPOSE The burden of urological diseases on the American public is immense in human and financial terms but it has been under studied. We undertook a project, Urologic Diseases in America, to quantify the burden of urological diseases on the American public. MATERIALS AND METHODS We identified public and private data sources that contain population based(More)
BACKGROUND More than 5% of the United States population has been diagnosed with nephrolithiasis and about one half of (first-time) stone formers will have a recurrence within 5 years. The prevalence of nephrolithiasis is concentrated among working age adults, yet little prior work has examined the economic burden of the disease on employers and their(More)
CONTEXT Prescription drugs are instrumental to managing and preventing chronic disease. Recent changes in US prescription drug cost sharing could affect access to them. OBJECTIVE To synthesize published evidence on the associations among cost-sharing features of prescription drug benefits and use of prescription drugs, use of nonpharmaceutical services,(More)
PURPOSE The incidence of urethral stricture disease in the United States is unknown. We estimated the impact of urethral stricture disease by determining its prevalence, costs and other measures of burden, including side effects and the need for surgical intervention. MATERIALS AND METHODS Analyses of services for urethral stricture disease were performed(More)
In this paper we examine spending by privately insured patients with four conditions often treated with specialty drugs: cancer, kidney disease, rheumatoid arthritis, and multiple sclerosis. Despite having employer-sponsored health insurance, these patients face substantial risk for high out-of-pocket spending. In contrast to traditional pharmaceuticals, we(More)
CONTEXT With drug spending rising rapidly for working-aged adults, many employers and health insurance providers have changed benefits packages to encourage use of fewer or less expensive drugs. It is unknown how these initiatives affect drug costs. OBJECTIVE To examine how innovations in benefits packages, such as those that include multitier formularies(More)
PURPOSE We quantified the burden of vesicoureteral reflux and ureteroceles in the United States by identifying trends in the use of health care resources and estimating the economic impact of the diseases. MATERIALS AND METHODS The analytical methods used to generate these results were described previously. RESULTS Annual inpatient hospitalizations for(More)
PURPOSE Several studies document the impact of benign prostatic hyperplasia (BPH) in working, aged men. Direct medical costs related to BPH treatment are largely borne by employees through higher premiums. However, indirect costs related to lost work are primarily borne by the employer. In this study we used claims data and absentee records from large(More)
OBJECTIVE To determine whether a pharmacy benefit that varies copayments for cholesterol-lowering (CL) therapy according to expected therapeutic benefit would improve compliance and reduce use of other services. METHODS Using claims data from 88 health plans, we studied 62 274 patients aged 20 years and older who initiated CL therapy between 1997 and(More)