Full Citation
Title: Prescription Drug Dispensing and Patient Costs After Implementation of a No Behavioral Health Cost-Sharing Law
Citation Type: Journal Article
Publication Year: 2024
ISBN:
ISSN: 2689-0186
DOI: 10.1001/JAMAHEALTHFORUM.2024.0198
NSFID:
PMCID:
PMID:
Abstract: <h3>Importance</h3><p>On January 1, 2022, New Mexico implemented a No Behavioral Cost-Sharing (NCS) law that eliminated cost-sharing for mental health and substance use disorder (MH/SUD) treatments in plans regulated by the state, potentially reducing a barrier to treatment for MH/SUDs among the commercially insured; however, the outcomes of the law are unknown.</p><h3>Objective</h3><p>To assess the association of implementation of the NCS with out-of-pocket spending for prescription for drugs primarily used to treat MH/SUDs and monthly volume of dispensed drugs.</p><h3>Design, Settings, and Participants</h3><p>This retrospective cohort study used a difference-in-differences research design to examine trends in outcomes for New Mexico state employees, a population affected by the NCS, compared with federal employees in New Mexico who were unaffected by NCS. Data were collected on prescription drugs for MH/SUDs dispensed per month between January 2021 and June 2022 for New Mexico patients with a New Mexico state employee health plan and New Mexico patients with a federal employee health plan. Data analysis occurred from December 2022 to January 2024.</p><h3>Exposure</h3><p>Enrollment in a state employee health plan or federal health plan.</p><h3>Main Outcomes and Measures</h3><p>The primary outcomes were mean patient out-of-pocket spending per dispensed MH/SUD prescription and the monthly volume of dispensed MH/SUD prescriptions per 1000 employees. A difference-in-differences estimation approach was used.</p><h3>Results</h3><p>The implementation of the NCS law was associated with a mean (SE) $6.37 ($0.30) reduction (corresponding to an 85.6% decrease) in mean out-of-pocket spending per dispensed MH/SUD medication (95% CI, −$7.00 to −$5.75). The association of implementation of NCS with the volume of prescriptions dispensed was not statistically significant.</p><h3>Conclusions and Relevance</h3><p>These findings suggest that the implementation of the New Mexico NCS law was successful in lowering out-of-pocket spending on prescription medications for MH/SUDs, but that there was no association of NCS with the volume of medications dispensed in the first 6 months after implementation. A key challenge is to identify policies that protect from high out-of-pocket spending while also promoting access to needed care.</p>
Url: https://jamanetwork.com/journals/jama-health-forum/fullarticle/2816751
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Authors: Golberstein, Ezra; Campbell, James M.; Maclean, Johanna Catherine; Harris, Samantha J.; Saloner, Brendan; Stein, Bradley D.
Periodical (Full): JAMA Health Forum
Issue: 3
Volume: 5
Pages: e240198-e240198
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