Melbourne Institute of Applied Economic and Social Research - Research Publications

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    Effects of Medicare Part D coverage gap closure on utilization of branded and generic drugs
    Liu, J ; Zhang, Y ; Kaplan, CM (WILEY, 2023-03)
    The Affordable Care Act included a provision to gradually eliminate the Medicare prescription drug coverage gap between 2011 and 2020, which substantially lower medication costs in the gap. Using 2007-2016 Medicare claims data, we estimate how filling the gap affects individuals' out-of-pocket spending and medication use, separately for branded and generic drugs. One important difficulty in estimating the policy impact is that around the same time, many blockbuster drugs commonly used by the Medicare population experienced patent expiration and began to see generic entry. Because generic entries affected different therapeutic classes at different times, we run difference-in-differences models by therapeutic category at the beneficiary-month level to isolate the effect of the gap closure from that of generic entry. Overall, we find that filling the gap substantially reduced out-of-pocket spending and increased the use of branded drugs, which had larger discount rates during the analysis period. Beneficiaries reaching the gap, at older ages, or with comorbidities experienced larger reduction in out-of-pocket spending. We show that without accounting for generic entry, the effect of filling the coverage gap on medication use is underestimated for branded drugs and overestimated for generic drugs.
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    Who is avoiding necessary health care during the COVID-19 pandemic?
    Zhang, Y ; Liu, J ; Scott, A (Melbourne Institute of Applied Economic and Social Research, 2020-06-01)
    Australians experiencing high levels of financial stress and mental distress are not seeking needed health care. This study looks into what policies could help encourage greater use of necessary health care to improve wellbeing and avoid more expensive care later on.
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    Using health care during the pandemic: should I stay or should I go?
    Zhang, Y ; Liu, J ; Scott, A (Melbourne Institute of Applied Economic and Social Research, 2020-09-01)
    The COVID-19 pandemic has caused significant financial and mental distress for many Australians, which according to results from Taking the Pulse of the Nation in early June, has caused some to avoid visiting a health care professional when needed. As the pandemic continues, are people still delaying seeing a doctor or has their been a resurgence in visits after people delayed their care earlier in the year? In this Research Insight, Professor Yuting Zhang, Dr. Judith Liu, and Professor Anthony Scott examine Australians' use of health care and telehealth, focusing on what changes have occured since early June. To understand how COVID-19 has impacted decision-making around seeing a health care professional, data from Taking the Pulse of the Nation have been used to see who has avoided seeing a doctor, who has sought health care, and who has used telehealth.
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    Who is ditching private health insurance during the pandemic?
    Zhang, Y ; Liu, J ; Scott, A (Melbourne Institute of Applied Economic and Social Research, 2020-11-01)
    Following the recent increase in private health insurance (PHI) premiums in October, as well as people's growing financial and mental stresses due to the COVID-19 pandemic, many Australians may be wondering whether they should drop or downgrade their PHI. In this Research Insight, authors Professor Yuting Zhang, Dr Judith Liu, and Professor Anthony Scott examine how Australians have changed their PHI memberships during the pandemic. Using data from the Melbourne Institute's Taking the Pulse of the Nation survey, they look specifically at who has dropped, downgraded or upgraded their PHI since March 2020.