Effect of switching to a high-deductible health plan on use of chronic medications.

Objective: To examine whether high-deductible health plans (HDHPs) that exempt prescription drugs from full cost sharing preserve medication use for major chronic illness, compared with traditional HMOs with similar drug cost sharing.

Data Sources/study Setting: We examined 2001-2008 pharmacy claims data of 3,348 continuously enrolled adults in a Massachusetts health plan for 9 months before and 24 months after an employer-mandated switch from a traditional HMO plan to a HDHP, compared with 20,534 contemporaneous matched HMO members. Both study groups faced similar three-tiered drug copayments.

Access to care and medicines, burden of health care expenditures, and risk protection: results from the World Health Survey.

Objectives: We assessed the contribution of health insurance and a functioning public sector to access to care and medicines and household economic burden.

Methods: We used descriptive and logistic regression analyses on 2002/3 World Health Survey data in 70 countries.

Results: Across countries, 286,803 households and 276,362 respondents contributed data.