In the United States, federally-funded health plans are mandated to measure the quality\nof care. Adherence-based medication quality metrics depend on completeness of administrative\nclaims data for accurate measurement. Low-cost generic programs (LCGPs) cause medications fills\nto be missing from claims data as medications are not adjudicated through a patientââ?¬â?¢s insurance.\nThis study sought to assess the magnitude of the impact of LCGPs on these quality measures.\nData from the 2012ââ?¬â??2013 Medical Expenditure Panel Survey (MEPS) were used. Medication fills\nfor select medication classes were classified as LCGP fills and individuals were classified as never,\nsometimes, and always users of LCGPs. Individuals were classified based on insurance type (private,\nMedicare, Medicaid, dual-eligible). The proportion of days covered (PDC) was calculated for each\nmedication class and the proportion of users with PDC ââ?°Â¥ 0.80 was reported as an observed metric for\nwhat would be calculated based on claims data and a true metric which included missing medication\nfills due to LCGPs. True measures of adherence were higher than the observed measures. The effectââ?¬â?¢s\nmagnitude was highest for private insurance and for medication classes utilized more often through\nLCGPs. Thus, medication-based quality measures may be underestimated due to LCGPs.
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