The Association of Medicaid expansion with prescription drug utilization and expenditure among low-income participants with asthma

This study estimated the association between the 2014 Medicaid expansion and asthma-related prescription drug utilization and expenditures among low-income adult participants with asthma, including those with uncontrolled asthma, in the United States. In this national analysis, using a pooled datase...

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Veröffentlicht in:The Journal of asthma Jg. ahead-of-print; H. ahead-of-print; S. 1 - 10
Hauptverfasser: Shi, Lu, Li, Tao, Luck, Jeff, Ghanem, Buthainah
Format: Journal Article
Sprache:Englisch
Veröffentlicht: England Taylor & Francis 02.11.2023
Schlagworte:
Affordable care act
medical expenditure panel surveys
preventive medication
two-part models
uncontrolled asthma
uncontrolled asthma
Affordable care act
two-part models
medical expenditure panel surveys
preventive medication
ISSN:0277-0903, 1532-4303, 1532-4303
Online-Zugang:Volltext
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Zusammenfassung:This study estimated the association between the 2014 Medicaid expansion and asthma-related prescription drug utilization and expenditures among low-income adult participants with asthma, including those with uncontrolled asthma, in the United States. In this national analysis, using a pooled dataset from 2007-2018 Medical Expenditure Panel Surveys (MEPS), regression discontinuity (D-RD) analyses estimated the association between Medicaid expansion and utilization of and expenditures for asthma-related prescription drugs among participants with asthma aged 26-64 with incomes below vs. at/above 138% of the federal poverty level (FPL). A sub-sample analysis was also conducted among participants with uncontrolled asthma. Utilization and expenditure outcomes were estimated using two-part models with logit as the first part and generalized linear models as the second part. Utilization of and total cost for asthma-related prescription drugs increased by 1.89 fills (p < 0.001) and $306.59 (p < 0.001) among participants with asthma with income below 138% FPL after Medicaid expansion. The utilization and total cost of both short-acting bronchodilators and inhaled corticosteroids (ICSs) increased after Medicaid expansion among participants with asthma with incomes below 138% FPL. Among participants with uncontrolled asthma with incomes below 138% FPL, utilization and expenditures increased after Medicaid expansion for all asthma-related prescription drugs and short-acting bronchodilators. Medicaid expansion was associated with increased utilization of and total expenditures for both quick-relief and preventive asthma medications among all low-income participants with asthma, but not with utilization of preventive medications among those with uncontrolled asthma.
Bibliographie:ObjectType-Article-1
SourceType-Scholarly Journals-1
ObjectType-Feature-2
content type line 23
ISSN:0277-0903
1532-4303
1532-4303
DOI:10.1080/02770903.2023.2213331