A well-regarded antiobiotic can't help prevent infections and pneumonia for patients leaving the hospital if high out-of-pocket costs prompt patients to skip filling prescriptions or take something less effective.
Plainsboro, NJ -- (SBWIRE) -- 10/04/2013 -- Linezolid, a well-regarded antibiotic, is used often by hospitals to combat infection during patients’ stays and prescribed to continue that fight after discharge. But when benefit plans charge high out-of-pocket costs for the drug, patients are more likely to skip or substitute it, and then are more likely to return to the hospital.
Those were the findings of a study published this month inThe American Journal of Managed Car. The study was led by Margaret K. Pasquale, PhD, of Comprehensive Health Insights, a subsidiary of Humana Inc., which jointly funded the study with Pfizer Inc. Pfizer markets oral linezolid under the brand name Zyvox. To read the complete study, click here.
Linezolid, available in both oral and intravenous forms, has received high marks for its ability to treat difficult infections, including ventilator acquired pneumonia and skin and soft-tissue infections (SSTIs). Controlling these infections is a challenge hospitals face in keeping down medical costs, and linezolid is a preferred option because it can be given intravenously while the patient is hospitalized, and then in a pill upon discharge. Thus, if taken properly, linezolid can help reduce the number of days a patient must stay in the hospital.
Of course, that plan falls apart if the patient fails to fill a prescription. Researchers used Humana’s database to identify Medicare patients prescribed oral linezolid between June 1, 2007, and April 30, 2011. A total of 1,062 Medicare patients were identified. Of the sample, 16.5 percent reversed a prescription for oral linezolid. Demographic and clinical factors showed that those who filled their prescription were more likely to have low-income/dual-eligibility status, and were also likely to have been hospitalized initially for a skin or soft-tissue condition, not pneumonia.
Oral linezolid is known to be an expensive medication. Researchers found varying co-payment and co-insurance levels among the study population. The mean out-of-pocket cost for recipients with a co-payment was $7.05, while the mean out-of-pocket cost for those who paid a percentage as co-insurance was $466.52. Of those patients whose out-of-pocket costs exceeded $100, 27 percent did not fill the prescription.
Among those reversing prescriptions, 73 percent received a different antibiotic and 27 percent received no antibiotic. But the “savings” for this group overall was short-lived, the researchers found. Infection-related hospitalizations were 14 percent higher for this group than for those who took oral linezolid as prescribed (23 percent vs. 9 percent). Rehospitalization is costly, as researchers calculated that the mean post-discharge cost for those who reversed their prescriptions was $1,280.93 higher than those who took the drug as directed.
Researchers speculated that high costs drive decisions to not fill prescriptions, as evidenced by the fact that the poorest patients were more likely to fill their orders for oral linezolid, since they had the lowest out-of-pocket costs. “If economic factors did indeed influence the decision to fill or reverse the linezolid prescription, then strategies to reduce member out-of-pocket costs (eg, benefit design) for all health plan members could enable better member access, and in turn, reduce total healthcare costs,” they wrote.
Mary Caffrey (609) 716-7777 x 144
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