Research Roundup: Drug Rationing; High-Deductible Plans; And Pharmacy Benefit Managers
Each week, KHN compiles a selection of recently released health policy studies and briefs.
JAMA Internal Medicine:
Prevalence And Severity Of Rationing During Drug Shortages: A National Survey Of Health System Pharmacists.
Hospital medication shortages in the United States are associated with decreased quality and/or quantity of life. In severe cases, shortages require clinicians to decide which patients receive needed medications and which do not (ie, rationing drugs between patients). Previous studies have proposed ethical allocation frameworks and assessed the associations of specific shortages. We conducted a national survey of hospital pharmacy managers to investigate current drug allocation and rationing practices of US hospitals during shortages. (Hantel et al, 3/25)
A Survey Of Americans With High-Deductible Health Plans Identifies Opportunities To Enhance Consumer Behaviors
Most high-deductible health plan (HDHP) enrollees do not engage in consumer behaviors such as price shopping. Why not? We surveyed 1,637 Americans in HDHPs—which can be linked to health savings accounts (HSAs) but usually are not—about factors that may predict, facilitate, or impede HDHP enrollees’ engagement in consumer behaviors. We found that having an HSA was associated with saving for future care, high financial literacy was associated with comparing prices and quality, and high confidence in talking with providers about costs and trying to negotiate prices was associated with engaging in these behaviors. Employer HSA contributions were the most frequent facilitator of saving, websites were the most frequent facilitators of comparing prices and quality, and “someone at the doctor’s office” was the most frequent facilitator of discussing costs with providers and trying to negotiate prices. The most frequent impediment to all of these behaviors was not having considered them when making decisions. These results suggest strategies that health plans, employers, and health systems should explore to promote greater engagement in consumer behaviors among patients in HDHPs. (Kullgren et al, 3/4)
Pharmacy Benefit Managers Practices Controversies What Lies Ahead
Pharmacy benefit managers (PBMs) are responsible for negotiating payment rates for a large share of prescription drugs distributed in the U.S. Recently, policymakers have expressed concern that certain PBMs’ business practices may not be consistent with public policy goals to improve the value of pharmaceutical spending. (Seeley and Kesselheim, 3/26)
The Henry J. Kaiser Family Foundation:
Poll: Most Americans Say HIV Is Serious Issue For The Country As Trump Administration Rolls Out New Plan To End HIV By 2030; Black And Hispanic Adults Report More Personal Concern Than White Adults
With the Trump administration launching a new domestic HIV effort, the latest KFF Health Tracking Poll finds a large majority of Americans (80%) view the HIV epidemic as a serious national issue, including a third (34%) who view it as “very serious.” Nearly half (46%) view it as a serious concern for people they know, including a quarter (24%) who view it as “very serious.” The poll is the first to probe in depth about the public’s views and knowledge of the nation’s HIV epidemic since President Trump used his Feb. 5 State of the Union address to announce the new initiative to significantly reduce the HIV epidemic in the U.S. within ten years. (3/26)