The impact of expansion of dyslipidemia drug coverage on cardiovascular disease incidence and costs under the National Health Insurance scheme
健保放寬降血脂藥物給付範圍對心血管疾病發生率及費用之影響
Journal
Taiwan Journal of Public Health
Journal Volume
39
Journal Issue
3
Pages
269-277
Date Issued
2020
Author(s)
Kuo P.-P.
Abstract
Objectives: Aiming to reduce the occurrence of cardiovascular disease (CVD), Taiwan's National Health Insurance (NHI) Administration expanded coverage for hypolipidemic drugs for high-risk patients, including patients with a history of CVD or diabetes in 2013. This study intended to evaluate the impact of this policy. Methods: Patients with diabetes but without a history of CVD (118,912 subjects) were selected as the study group, and patients with hypertension but without a history of CVD or diabetes (150,930 subjects) were the comparison group. Using August 1, 2013, as the cut-off point we defined 3 years each in the pre- and postpolicy periods. Generalized estimation equation (GEE) models with a difference-in-differences analysis were used to estimate the effects of the new policy in 2010 and 2016. Outcome variables included the likelihood of receiving hypolipidemic drugs, occurrence of CVD (acute myocardial infarction and ischemic stroke), and expenses for drugs and CVD. Results: After introduction of the policy, subjects in the study group were more likely to receive hypolipidemic drugs (OR=1.095, p<0.001), and less likely to have CVD (OR=0.914, p=0.0046) than subjects in the comparison group. The subjects in the study group also had lower expenses for hypolipidemic drugs (β=-0.016, p=0.0019), but the lower expenses for CVD did not reach the significance level (β=-0.087, p=0.1504). Conclusions: The expanded coverage for hypolipidemic drugs significantly increased the use of medications for high-risk patients, and reduced the occurrence of CVD in Taiwan. Long-tern evaluation of this medication policy is recommended.
Publisher
Chinese Public Health Association of Taiwan
Type
journal article