Dataset Information

National Trends in Nonstatin Use and Expenditures Among the US Adult Population From 2002 to 2013: Insights From Medical Expenditure Panel Survey.

ABSTRACT: BACKGROUND:Evidence supporting nonstatin lipid-lowering therapy in atherosclerotic cardiovascular disease risk reduction is variable. We aim to examine nonstatin utilization and expenditures in the United States between 2002 and 2013. METHODS AND RESULTS:We used the Medical Expenditure Panel Survey database to estimate national trends in nonstatin use and cost (total and out-of-pocket, adjusted to 2013 US dollars using a gross domestic product deflator) among adults 40 years or older. Nonstatin users increased from 3 million (2.5%) in 2002-2003 (20.1 million prescriptions) to 8 million (5.6%) in 2012-2013 (45.8 million prescriptions). Among adults with atherosclerotic cardiovascular disease, nonstatin use increased from 7.5% in 2002-2003 to 13.9% in 2012-2013 after peaking at 20.3% in 2006-2007. In 2012-2013, 15.9% of high-intensity statin users also used nonstatins, versus 9.7% of low/moderate-intensity users and 3.6% of statin nonusers. Nonstatin use was significantly lower among women (odds ratio 0.80; 95% confidence interval 0.75-0.86), racial/ethnic minorities (odds ratio 0.41; 95% confidence interval 0.36-0.47), and the uninsured (odds ratio 0.47; 95% confidence interval 0.40-0.56). Total nonstatin expenditures increased from $1.7 billion (out-of-pocket cost, $0.7 billion) in 2002-2003 to $7.9 billion (out-of-pocket cost $1.6 billion) in 2012-2013, as per-user nonstatin expenditure increased from $550 to $992. Nonstatin expenditure as a proportion of all lipid-lowering therapy expenditure increased 4-fold from 8% to 32%. CONCLUSIONS:Between 2002 and 2013, nonstatin use increased by 124%, resulting in a 364% increase in nonstatin-associated expenditures.

SUBMITTER: Salami JA

PROVIDER: S-EPMC5850149 | biostudies-literature | 2018 Jan

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

National Trends in Nonstatin Use and Expenditures Among the US Adult Population From 2002 to 2013: Insights From Medical Expenditure Panel Survey.

Salami Joseph A JA Warraich Haider J HJ Valero-Elizondo Javier J Spatz Erica S ES Desai Nihar R NR Rana Jamal S JS Virani Salim S SS Blankstein Ron R Khera Amit A Blaha Michael J MJ Blumenthal Roger S RS Katzen Barry T BT Lloyd-Jones Donald D Krumholz Harlan M HM Nasir Khurram K

Journal of the American Heart Association 20180122 2

<h4>Background</h4>Evidence supporting nonstatin lipid-lowering therapy in atherosclerotic cardiovascular disease risk reduction is variable. We aim to examine nonstatin utilization and expenditures in the United States between 2002 and 2013.<h4>Methods and results</h4>We used the Medical Expenditure Panel Survey database to estimate national trends in nonstatin use and cost (total and out-of-pocket, adjusted to 2013 US dollars using a gross domestic product deflator) among adults 40 years or ol ...[more]

PMID: 29358195

Similar Datasets

Project description:BackgroundA comprehensive picture of how the US population engages in specialty care use is lacking, even though redesign models focused on specialty care are becoming more popular.ObjectiveTo describe the type of provider, primary care or specialist, most often seen by individuals, to test associations between type of provider most often seen and insurance coverage, and to test associations between the number of generalist and specialist visits and insurance coverage.DesignCross-sectional analysis of 2013-2016 Medicaid Expenditure Panel Survey. Logistic and negative binomial models were used in multivariate regression modeling.ParticipantsDepending on the analysis, the study samples include between 71,402 and 79,518 US residents.Main measuresIndividuals' provider type most often seen, primary care visits, and specialist visits were reported.Key resultsMore than half of the sample (55%) predominantly visited primary care providers (or generalists), and 36% predominantly visited specialists. Among individuals primarily visiting generalists, 80% visited only one type of primary care provider, and 24% also visited one or more specialists. Among individuals primarily visiting specialists, 48% visited only one type of specialist, and 47% did not visit any generalists in the year. Among Medicare enrollees, 50% predominantly visited specialists, and 40% predominantly visited generalists. Medicare enrollment was associated with greater odds of predominantly visiting specialists (p < 0.05), and Medicare-Medicaid enrollment and having no insurance were associated with lower odds of predominantly visiting specialists (p < 0.05). Medicare enrollment was associated with 13% more generalist visits and 35% more specialist visits, and Medicare-Medicaid enrollment was associated with 38% more generalist visits and 15% more specialist visits (all p < 0.05).ConclusionsGiven the overall frequency of specialty care use and the reliance on multiple specialists in any given year, particularly among Medicare enrollees, public payers are uniquely positioned to promote specialty care redesign and champion improved coordination between specialists.

Project description:BackgroundCatastrophic health expenditures (CHE) are out-of-pocket payments (OOP) that exceed a predefined percentage or threshold of a household's resources, usually 40 %, that can push households into poverty in China. We analyzed the trends in the incidence and intensity, and explored the determinants, of CHE, and proposed policy recommendation to address CHE.MethodsA unique 5-year national urban-rural panel database was constructed from the China Family Panel Studies (CFPS) surveys. CHE incidence was measured by calculating headcount (percentage of households incurring CHE to the total household sample) and intensity was measured by overshoot (degree by which an average out of pocket health expenditure exceeds the threshold of the total sample). A linear probability model was employed to assess the trend in the net effect of the determinants of CHE incidence and a random effect logit model was used to analyse the role of the characteristics of the household head, the household and household health utilization on CHE incidence.ResultsCHE determinants vary across time and geographical location. From 2010 to 2018, the total, urban and rural CHE incidence all showed a decreasing tend, falling from 14.7 to 8.7 % for total households, 12.5-6.6 % in urban and 16.8-10.9 % in rural areas. CHE intensity decreased in rural (24.50-20.51 %) and urban (22.31-19.57 %) areas and for all households (23.61-20.15 %). Inpatient services were the most important determinant of the incidence of CHE. For urban households, the random effect logit model identified household head (age, education, self-rated health); household characteristics (members 65 + years, chronic diseases, family size and income status); and healthcare utilization (inpatient and outpatient usage) as determinants of CHE. For rural areas, the same variables were significant with the addition of household head's sex and health insurance.ConclusionsThe incidence and intensity of CHE in China displayed a downward trend, but was higher in rural than urban areas. Costs of inpatient service usage should be a key intervention strategy to address CHE. The policy implications include improving the economic level of poor households, reforming health insurance and reinforcing pre-payment hospital insurance methods.

Dataset Information

National Trends in Nonstatin Use and Expenditures Among the US Adult Population From 2002 to 2013: Insights From Medical Expenditure Panel Survey.

Publications

National Trends in Nonstatin Use and Expenditures Among the US Adult Population From 2002 to 2013: Insights From Medical Expenditure Panel Survey.

Similar Datasets

OmicsDI is part of the ELIXIR infrastructure

Tweets