Medication Usage Pattern for Asthma and Acute Episodes

Enrollment in a high-deductible health plan (HDHP) is not linked to changes in asthma medication use or asthma exacerbations when medications are exempt from the deductible, as per the study published in JAMA Pediatrics.

Clinical guidelines recommend the use of controller medications, but sticking to these medications is suboptimal, putting those affected at risk for asthma exacerbations.

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‘Policy makers should adopt value-based designs and other policies exempting important medications for asthma and other chronic conditions.’
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High out-of-pocket costs have been associated with decreased controller medication use and adverse asthma outcomes for children and adults.

Evidence about HDHPs has come from studies focused on adult populations. The study team examined how enrollment in HDHPs may affect asthma controller medication use and exacerbation in children.

"One challenge of insurance design is balancing affordable coverage with access to necessary care for chronic conditions for both children and adults," said Dr. Galbraith.

"Our findings highlight the potential protective effect of exempting asthma medications from the deductible in high-deductible health plans."

Study includes children (ages 4 to 17) and adults (ages 18-64) years with persistent asthma who switched from traditional plans to HDHPs during a 24-month period.

Children switching to HDHPs experienced small decreases in annual 30-day fills for inhaled corticosteroid-long-acting beta agonist medications but not for other controller medications.

ADults switching to HDHPs did not have significant reductions in 30-day fills for any controller medications. There were no statistically significant differences in medication adherence, oral steroid bursts, or asthma-related ED visits for children or adults.

Regarding possible next steps, Dr. Galbraith adds, "Asthma is a major cause of preventable disease burden for both children and adults. Policy makers should consider adopting value-based designs and other policies exempting important medications for asthma and other chronic conditions--which might prevent adverse clinical outcomes--from the deductible."

Source-Medindia