Effects of Adopting Preventive Drug Lists on Medication Costs and Disparities by Income Over 2 Years: A Natural Experiment for Translation in Diabetes (NEXT-D) Study
Main finding · Pre- to post-out-of-pocket spending for all medicationsResult — go to the resultRelative change −29.7% 95% CI −36.0 to −23.4%Authors' conclusion
PDLs offer an effective strategy for employers and insurers to lower member cost sharing and encourage increased use of important medications to prevent or manage chronic illnesses. For patients with diabetes, especially those with lower incomes, PDL coverage resulted in substantial and persistent reductions in out-of-pocket medication costs, medication use increases, and some increased use of more expensive products.
Study context
- Population
- Patients with diabetes aged 12–64 years insured in commercial health plans (Optum Clinformatics Data Mart, January 2003 to December 2017)
- Participants
- 5,582 vs 5,582
- Comparison
- PDL coverage vs no PDL
- PDLn = 5,582
- Controln = 5,582reference
- Outcome
- Pre- to post-out-of-pocket spending for all medications
- Follow-up
- Year 2
Methodological detailsmatched control group, natural experiment
- Matched control group
- Natural experiment
Main finding
As reported in the abstract
Relative change
−29.7%
95% CI −36.0 to −23.4%
PDLvs Control
relative change −29.7% (95% CI −36.0 to −23.4%)
Further findings
Out-of-pocket spending by income (higher- and lower-income PDL members) · year 2
- Significant reduction for all medications
- 30%
- Significant reduction for key therapeutic classes
- range −23 to −67%
Use of key therapeutic classes
- Significant increase, overall population
- range 8-15%
- Significant increase, higher- and lower-income PDL members
- range 9-50%
Original publication
Effects of Adopting Preventive Drug Lists on Medication Costs and Disparities by Income Over 2 Years: A Natural Experiment for Translation in Diabetes (NEXT-D) Study. Diabetes Care. Published 8 October 2024. doi:10.
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