Introduction: Medicare patients in the United States may face high out-of-pocket (OOP) costs for specialty inflammatory bowel disease (IBD) medications.
Methods: We conducted a study of Medicare OOP costs for specialty IBD medications between 2020 and 2022 and compared them to incomes of typical Medicare beneficiaries.
Results: In 2022, median OOP costs ranged from 6.4% to 59.2% of annual income for a Medicare patient with approximately median income. Inflation-adjusted OOP costs for most medications increased between 2020 and 2022 though decreased for infliximab and its biosimilars.
Discussion: OOP costs may limit many Medicare beneficiaries' access to specialty IBD medications.
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http://dx.doi.org/10.14309/ajg.0000000000002057 | DOI Listing |
PLoS One
January 2025
Lagos State Health Management Agency, Lagos, Nigeria.
Background: Each year, millions of people in low-and middle-income countries such as Nigeria are forced into poverty and financial ruin due to out-of-pocket (OOP) healthcare expenses. Our study assessed the prevalence and determinants of Catastrophic Healthcare Expenditure (CHE) experienced by households in Lagos, Nigeria.
Methods: A descriptive community-based cross-sectional survey was conducted on 2492 households in Lagos from December 2022 to March 2023 in 4 Local Government Areas (LGAs) using a multistage sampling technique.
BMJ Open Qual
January 2025
Program on Health Systems Development - Philippine Primary Care Studies, Center for Integrative and Development Studies, University of the Philippines Diliman, Quezon City, Philippines.
Background: This study aimed to determine the effects of primary care interventions on healthcare utilisation and estimated out-of-pocket (OOP) expenses in selected urban, rural and remote settings in the Philippines.
Methodology: Context-specific measures relating to expanding healthcare provider networks, augmenting the health human workforce and subsidising transportation costs were implemented to strengthen primary care systems. In this study, two key outcomes were monitored: (1) monthly healthcare utilisation measured by the total number of outpatient consultations per site and (2) change in OOP expenses from baseline to endline within a 1 year study period.
Lancet Reg Health West Pac
January 2025
Background: South Korea has witnessed a rapid increase in health expenditure, reaching USD 135 billion in 2021 and accounting for 9.3% of its GDP, surpassing the OECD average. Despite achieving universal health coverage, significant gaps remain in service coverage, leading to high out-of-pocket (OOP) expenses that expose households to financial burdens.
View Article and Find Full Text PDFBMC Health Serv Res
January 2025
Department of Preventive Medicine, Daegu Catholic University School of Medicine, Daegu, Korea.
Background: Health literacy (HL) is crucial for effective healthcare utilization, but its relationship with private health insurance (PHI) enrollment and medical expenditure in South Korea remains unexplored.
Objectives: This study aimed to examine the associations between HL, PHI enrollment, and annual out-of-pocket (OOP) medical expenditure in South Korea's universal healthcare system.
Methods: Using data from the 2021 Korea Health Panel Study, we analyzed 5,469 participants aged 19-65.
Obstet Gynecol
February 2025
Department of Cardiology, the Department of Obstetrics and Gynecology, and the Division of Research, Kaiser Permanente Northern California, and Graduate Medical Education, Kaiser Permanente Oakland Medical Center, Oakland, and the Division of Research, Kaiser Permanente, Pleasanton, California.
Objective: To investigate the effects of the Affordable Care Act (ACA) and its elimination of cost sharing on contraception utilization, pregnancy rates, and abortion rates.
Methods: We conducted a retrospective cohort study within a health care system serving more than 4.5 million insured members across 21 medical centers and 250 clinics.
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