Impact of the Physician Payments Sunshine Act on Prescription Drug Utilization and Spending

医生支付阳光法案对处方药使用和支出的影响

• 批准号: 9807060
• 负责人: Jing Li
• 金额: $ 9.99万
• 依托单位: WEILL MEDICAL COLL OF CORNELL UNIV
• 依托单位国家: 美国
• 财政年份: 2019
• 资助国家: 美国
• 起止时间: 2019-07-01 至 2020-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9807060
• 关键词: Impact; Physician; Payments; Sunshine; Act

PROJECT SUMMARY The study proposes to evaluate the early impact of the Physician Payments Sunshine Act (PPSA), an Affordable Care Act provision that requires public disclosure of payments made from medical product manufacturers, including pharmaceutical companies, to physicians starting August 2013. The long-term goal of this proposal is to contribute to our understanding of how disclosure of financial relationships between physicians and the pharmaceutical industry impacts healthcare affordability, efficiency and cost transparency. The study has the following specific aims: 1) determine the effects of the PPSA on overall utilization of and spending on prescription drugs in the two drug classes: statins and antipsychotics; 2) determine the effects of the PPSA on utilization and spending separately for brand-name drugs with and without generic equivalents as well as generic drugs in each class; 3) examine heterogeneity in the effects of the PPSA by physician specialty, prescribing volume in the pre-PPSA period, and payment from pharmaceutical companies. We propose to analyze data from Health Care Cost Institute containing medical and pharmacy claims from three national insurers covering 50 million individuals. Our quasi-experimental research design exploits the fact that two states, Massachusetts and Vermont, implemented their own public disclosure legislations similar to the PPSA before 2013. We will employ difference-in-difference and event study approaches, using MA and VT as the control group. Our treatment group includes six of the remaining Northeastern states without reporting mandates prior to the PPSA. Therefore, our research design allows us to estimate the differences in utilization and spending measures before versus after the implementation of the PPSA among commercially insured patients in the treatment states relative to the control states. The proposed research is expected to provide one of the first pieces of rigorous evidence on the effectiveness of the PPSA in improving the efficiency and affordability of prescription drug provision, as well as the underlying mechanism of such effects. It will also shed light on potential unintended consequences of the PPSA. It will provide timely and critical information as well as further legislative efforts aimed at curbing financial relationships between pharmaceutical companies and physicians.

项目概要 该研究建议评估《医生支付阳光法案》(PPSA) 的早期影响，该法案是一项 《平价医疗法案》条款要求公开披露医疗产品的付款情况 从 2013 年 8 月开始，包括制药公司在内的制造商向医生提供服务。长期目标 该提案旨在帮助我们理解如何披露公司之间的财务关系 医生和制药行业影响医疗保健的可负担性、效率和成本透明度。 该研究有以下具体目标：1）确定 PPSA 对整体利用率和 两类药物的处方药支出：他汀类药物和抗精神病药物； 2) 确定效果 PPSA 分别针对具有和不具有仿制药等价物的品牌药物使用和支出 以及各类别的仿制药； 3) 检查医生 PPSA 效果的异质性 专业、PPSA 之前期间的处方量以及制药公司的付款。 我们建议分析来自医疗保健成本研究所的数据，其中包含来自 三大全国性保险公司，覆盖 5000 万人。我们的准实验研究设计利用了这一事实 马萨诸塞州和佛蒙特州这两个州实施了自己的公开披露立法，类似于 2013 年之前的 PPSA。我们将采用双重差分和事件研究方法，使用 MA 和 VT 作为对照组。我们的治疗组包括尚未报告的东北部剩余州中的六个 PPSA 之前的授权。因此，我们的研究设计使我们能够估计利用率的差异 商业保险实施 PPSA 前后的支出措施 相对于对照状态，处于治疗状态的患者。 拟议的研究预计将提供第一批关于有效性的严格证据之一 PPSA 在提高处方药供应效率和可负担性方面的作用，以及 这种影响的根本机制。它还将揭示潜在的意外后果 聚丙稀酸。它将提供及时和重要的信息以及旨在遏制 制药公司和医生之间的财务关系。