Evaluating the Impact of Eliminating Copayments for Tobacco Cessation Pharmacotherapy

• Published in: Medical care 2018-11, Vol.56 (11), p.912-918
• Main Authors: Young-Wolff, Kelly C, Adams, Sara R, Klebaner, Daniella, Adams, Alyce S, Campbell, Cynthia I, Satre, Derek D, Prochaska, Judith J
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Aged; California; Confidence intervals; Deductibles and Coinsurance - legislation & jurisprudence; Drug therapy; Electronic health records; Electronic medical records; Female; Humans; Income; Income - statistics & numerical data; Male; Middle Aged; Nicotine; Patient Protection & Affordable Care Act 2010-US; Patient Protection and Affordable Care Act - legislation & jurisprudence; Patients; Pharmacology; Smoking; Smoking cessation; Smoking Cessation - methods; Smoking Cessation - statistics & numerical data; Socioeconomic Factors; Tobacco; Tobacco Use Cessation - methods; Tobacco Use Cessation - statistics & numerical data; Tobacco Use Cessation Devices - economics; Young Adult
• ISSN: 0025-7079; 1537-1948
• DOI: 10.1097/MLR.0000000000000987

OBJECTIVES:We examined the impact of the Affordable Care Act–mandated elimination of tobacco cessation pharmacotherapy (TCP) copayments on patient use of TCP, overall and by income. METHODS:Electronic health record data captured any and combination (eg, nicotine gum plus patch) TCP use among adult smokers newly enrolled in Kaiser Permanente Northern California (KPNC). KPNC eliminated TCP copayments in 2015. We included current smokers newly enrolled in the first 6 months of 2014 (before copayment elimination, N=16,199) or 2015 (after elimination, N=16,469). Multivariable models estimated 1-year changes in rates of any TCP fill, and of combination TCP fill, and tested for differences by income (