New research led by experts at the Harvard Pilgrim Health Care Institute has found that switching to a high-deductible health plan (HDHP) can affect asthma medication use and exacerbations in children.
The study findings, published earlier this month in JAMA Pediatrics, have suggested that enrolling in HDHP may not be associated with changes in asthma medication use or asthma exacerbations when medications are exempt from the deductible, according to Science Daily.
A high-deductible health plan is a type of health insurance plan that has lower premiums but higher deductibles than a traditional health plan.
Clinical guidelines suggest using controller medications to treat asthma, but adherence to such medications is generally suboptimal, putting asthmatics at risk for acute exacerbations.
It has been found that high out-of-pocket costs are associated with decreased asthma controller medication use and adverse outcomes in children as well as adults.
Lead author Dr. Alison Galbraith of Harvard Medical School said, “One challenge of insurance design is balancing affordable coverage with access to necessary care for chronic conditions for both children and adults.”
“Our findings highlight the potential protective effect of exempting asthma medications from the deductible in high-deductible health plans,” she added.
The study population included children aged between 4 and 17, and adults aged between 18 and 64 who have persistent asthma and switched from traditional plans to HDHPs during a 24-month period.
The researchers found that children enrolling in HDHPs experienced a small decrease in annual 30-day fills for inhaled asthma medications but not for other asthma controller medications. These changes were not seen in those who remained in traditional plans.
However, adults enrolling in HDHPs did not have significant reductions in 30-day fills for any asthma controller medications.
Also, the researchers found no statistically significant differences in medication adherence, oral steroid bursts, or asthma-related ED visits in children or adults, according to Science Daily. “Asthma is a major cause of preventable disease burden for both children and adults,” Dr. Galbraith said. “Policymakers 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.”
