Dataset Information

Budgetary Consequences of High Medical Spending Across Age and Social Status: Evidence from the Consumer Expenditure Surveys.

ABSTRACT: BACKGROUND AND OBJECTIVES:This study examines high medical spending among younger, midlife, and older households. RESEARCH DESIGN AND METHODS:We investigate high medical spending using data from the 2010 through March 2018 Consumer Expenditures Surveys (n?=?92,951). We classify and describe high medical spenders relative to others within three age groups (household heads age 25-44, 45-64, and 65+) using finite mixture models and multinomial logistic regression, respectively. We then use hierarchical linear models to estimate the effects of high medical spending on nonmedical spending. RESULTS:Among younger households, high medical spending is positively associated with higher education and increased spending on housing and food. Among older households, high medical spending is associated with lower education and decreased nonmedical spending. DISCUSSION AND IMPLICATIONS:Earlier in the life course, high medical spending is more likely to indicate an investment in future household well-being, while at older ages, high medical spending is likely to indicate medical consumption.

SUBMITTER: Mueller CW

PROVIDER: S-EPMC7491440 | biostudies-literature | 2020 Sep

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Budgetary Consequences of High Medical Spending Across Age and Social Status: Evidence from the Consumer Expenditure Surveys.

Mueller Collin W CW Charron-Chénier Raphaël R Bartlett Bryce J BJ Brown Tyson H TH

The Gerontologist 20200901 7

<h4>Background and objectives</h4>This study examines high medical spending among younger, midlife, and older households.<h4>Research design and methods</h4>We investigate high medical spending using data from the 2010 through March 2018 Consumer Expenditures Surveys (n = 92,951). We classify and describe high medical spenders relative to others within three age groups (household heads age 25-44, 45-64, and 65+) using finite mixture models and multinomial logistic regression, respectively. We th ...[more]

PMID: 31925949

Similar Datasets

Project description:ObjectivesTo investigate the consequences of endogeneity bias on the estimated effect of having health insurance on health at age 63 or 64, just before most people qualify for Medicare, and to simulate the implications for total and public insurance (Medicare and Medicaid) spending on newly enrolled beneficiaries in their first years of Medicare coverage.DataThe longitudinal Health and Retirement Survey of people who were 55-61 years old in 1992, followed through biannual surveys to age 63-64 or until 2000 (whichever came first), and those who were 66-70 years olds from the Medicare Current Beneficiary Surveys, 1992-1998.Study designInstrumental variable (IV) estimation of a simultaneous equation model of insurance choice and health at age 63-64 as a function of baseline health and sociodemographic characteristics in 1992 and endogenous insurance coverage over the observation period.FindingsContinuous insurance coverage is associated with significantly fewer deaths prior to age 65 and, among those who survive, a significant upward shift in the distribution of health states from fair and poor health with disabilities to good to excellent health. Treating insurance coverage as endogenous increases the magnitude of the estimated effect of having insurance on improved health prior to age 65. The medical spending simulations suggest that if the near-elderly had continuous insurance coverage, average annual medical spending per capita for new Medicare beneficiaries in their first few years of coverage would be slightly lower because of the improvement in health status. In addition, total Medicare and Medicaid spending for new beneficiaries over their first few years of coverage would be about the same or slightly lower, even though more people survive to age 65.ConclusionsExtending insurance coverage to all Americans between the ages of 55 and 64 would improve health (increase survival and shift people from good-fair-poor health to excellent-very good health) at age 65, and possibly reduce total short-term spending by Medicare and Medicaid for newly eligible Medicare beneficiaries, even though more people would enter the program because of increased survival.

Project description:ImportanceSome drugs are heavily marketed through direct-to-consumer advertising.ObjectiveTo identify drug characteristics associated with a greater share of promotional spending on advertising directly to consumers.Design, setting, and participantsExploratory cross-sectional analysis of drug characteristics and promotional spending for the 150 top-selling branded prescription drugs in the US in 2020 as identified from IQVIA National Sales Perspectives data. Promotional spending data were provided by IQVIA ChannelDynamics.ExposuresDrug characteristics (total 2020 sales; total 2020 promotional spending; clinical benefit ratings; number of indications, off-label use; molecule type; nature of condition treated; administration type; generic availability; US Food and Drug Administration [FDA] approval year, World Health Organization anatomical therapeutic chemical classification; Medicare annual mean spending per beneficiary; percent sales attributable to the drug; market size; market competitiveness) assessed from health technology assessment agencies (France's Haute Autorité de Santé and Canada's Patented Medicine Prices Review Board) and drug data sources (Drugs@FDA, the FDA Purple Book, Lexicomp, Merative Marketscan Research Databases, and Medicare Spending by Drug data).Main outcomes and measuresProportion of total promotional spending allocated to direct-to-consumer-advertising for each drug.ResultsThe 2020 median proportion of promotional spending allocated to direct-to-consumer advertising was 13.5% (IQR, 1.96%-36.6%); median promotional spending, $20.9 million (IQR, $2.72-$131 million); and median total sales, $1.51 billion (IQR, $0.97-$2.26 billion). Of the 150 best-selling drugs, 16 were missing data and key covariates; therefore, the primary study sample comprised 134 drugs. After adjustment for multiple drug characteristics, the mean proportion of total promotional spending allocated to direct-to-consumer advertising for the remaining 134 drugs was an absolute 14.3% (95% CI, 1.43%-27.2%; P = .03) higher for those with low added clinical benefit than for those with high added clinical benefit and an absolute 1.5% (95% CI, 0.44%-2.56%; P = .005) higher for each 10% increase in total sales.Conclusions and relevanceAmong top-selling US drugs in 2020, a rating of lower added benefit and higher total drug sales were associated with a higher proportion of manufacturer total promotional spending allocated to direct-to-consumer advertising. Further research is needed to understand the implications of these findings.

Dataset Information

Budgetary Consequences of High Medical Spending Across Age and Social Status: Evidence from the Consumer Expenditure Surveys.

Publications

Budgetary Consequences of High Medical Spending Across Age and Social Status: Evidence from the Consumer Expenditure Surveys.

Similar Datasets

OmicsDI is part of the ELIXIR infrastructure

Tweets