Evaluating the Impact of a Value-based Prescription Drug Formulary (VBF-e)

Kaiser Permanente

Status: Completed

Conditions: Value-Based Health Insurance

Treatments: Other: Value-based Formulary

Study type: Observational

Funder types: Other

Identifiers

NCT04904055

218066

Details and patient eligibility

About

The objective of this study is to evaluate the impact of the value-based formulary on patient out-of-pocket spending and health plan spending as well as the impact of the value-based formulary on medication use, emergency department visits, hospitalizations, and outpatient office visits.

Enrollment: 36,333 patients

Sex: All

Ages: Under 64 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Individuals:

  • aged 0-64

  • Continuously enrolled in an employer-sponsored health plan for at least 12 months (with one-month allowable gap) prior to the index date

    • For individuals in the exposed group, the index date is defined as the start date of value-based formulary implementation at the employer group level
    • For individuals in the control group, the index date is defined as the index date of the matched exposed individual

• Employer groups:

  • that transition to the value-based formulary if they transitioned all enrollees in that employer group (no individual selection)

Exclusion criteria

• Individuals with:

• missing gender information
• missing zip code level demographics at all member months

Trial design

36,333 participants in 2 patient groups

Value-based Formulary Beneficiaries

Description:

enrolled in the value-based formulary

Treatment:

Other: Value-based Formulary

Standard Formulary Beneficiaries

Description:

enrolled in a standard (i.e., non-value-based formulary)