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Record W2027586487 · doi:10.1371/journal.pone.0090434

A Systematic Review of Cost-Sharing Strategies Used within Publicly-Funded Drug Plans in Member Countries of the Organisation for Economic Co-Operation and Development

2014· review· en· W2027586487 on OpenAlexaff
Lianne Barnieh, Fiona Clement, Anthony Harris, Marja Blom, Cam Donaldson, Scott Klarenbach, Don Husereau, Diane Lorenzetti, Braden Manns

Bibliographic record

VenuePLoS ONE · 2014
Typereview
Languageen
FieldEconomics, Econometrics and Finance
TopicHealth Systems, Economic Evaluations, Quality of Life
Canadian institutionsUniversity of OttawaUniversity of AlbertaUniversity of Calgary
Fundersnot available
KeywordsFormularyCost sharingBusinessIncentiveSampling frameMedical prescriptionPrescription drugGuidelineActuarial sciencePublic economicsMedicineEnvironmental healthEconomicsFamily medicine

Abstract

fetched live from OpenAlex

BACKGROUND: Publicly-funded drug plans vary in strategies used and policies employed to reduce continually increasing pharmaceutical expenditures. We systematically reviewed the utilization of cost-sharing strategies and physician-directed prescribing regulations in publicly-funded formularies within member nations of the Organization of Economic Cooperation and Development (OECD). METHODS & FINDINGS: Using the OECD nations as the sampling frame, a search for cost-sharing strategies and physician-directed prescribing regulations was done using published and grey literature. Collected data was verified by a system expert within the prescription drug insurance plan in each country, to ensure the accuracy of key data elements across plans. Significant variation in the use of cost-sharing mechanisms was seen. Copayments were the most commonly used cost-containment measure, though their use and amount varied for those with certain conditions, most often chronic diseases (in 17 countries), and by socio-economic status (either income or employment status), or with age (in 15 countries). Caps and deductibles were only used by five systems. Drug cost-containment strategies targeting physicians were also identified in 24 countries, including guideline-based prescribing, prescription monitoring and incentive structures. CONCLUSIONS: There was variable use of cost-containment strategies to limit pharmaceutical expenditures in publicly funded formularies within OECD countries. Further research is needed to determine the best approach to constrain costs while maintaining access to pharmaceutical drugs.

Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.

How this classification was reachedexpand

Full frame machine prediction

Teacher imitation

Not calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.

metaresearch head score (Codex)0.022
metaresearch head score (Gemma)0.105
Version: metacan-v3-hybrid-931329e0061cValidation status: machine_predicted_unvalidated
Candidate categoriesnone
Consensus categoriesnone
DomainCandidate signal: none · Consensus signal: none
Study designCandidate signal: Systematic review · Consensus signal: Systematic review
GenreCandidate signal: Review · Consensus signal: Review
Teacher disagreement score0.024
Threshold uncertainty score0.115

Distilled classifier scores by category (both heads)

CategoryCodexGemma
Metaresearch0.0220.105
Meta-epidemiology (narrow)0.0010.001
Meta-epidemiology (broad)0.0060.007
Bibliometrics0.0240.028
Science and technology studies0.0010.001
Scholarly communication0.0040.003
Open science0.0020.002
Research integrity0.0020.001
Insufficient payload (model declined to judge)0.0040.000

Machine scores (provisional)

The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.

Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.

Opus teacher head0.473
GPT teacher head0.426
Teacher spread0.047 · how far apart the two teachers sit on this one work
Validation statusscore_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from it

Classification

machine, unvalidated

Machine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.

The models applied no category: nothing in the taxonomy fit this work.
Study designSystematic review
Domainnot available
GenreReview

How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".

Quick stats

Citations46
Published2014
Admission routes1
Has abstractyes

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Same venuePLoS ONESame topicHealth Systems, Economic Evaluations, Quality of LifeFrench-language works237,207