How to make value-based health insurance designs more effective? A systematic review and meta-analysis

Gundula Krack ()
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Gundula Krack: Ludwig-Maximilians University

The European Journal of Health Economics, 2019, vol. 20, issue 6, No 6, 856 pages

Abstract: Abstract Value-based health insurance designs (VBIDs) are one approach to increase adherence to highly effective medications and simultaneously contain rising health care costs. The objective of this systematic review was to identify VBID effects on adherence and incentive designs within these programs that were associated with higher effects. Eight economic and medical databases were searched for literature. Random effects meta-analyses and mixed effects meta-regressions were used to synthesize VBID effects on adherence. Thirteen references with evaluation studies, including 12 patient populations with 79 outcomes, were used for primary meta-analyses. For qualitative review and sensitivity analyses, up to 19 references including 20 populations with 119 outcomes were used. Evidence of synthesized effects was good, because references with high risk of bias were excluded. VBIDs significantly increased adherence in all indication areas. Highest effects were found in medications indicated in heart diseases (4.05%-points, p

Keywords: Value-based health insurance design; Health insurance; Cost sharing; Adherence; Meta-analysis (search for similar items in EconPapers)
JEL-codes: D81 H75 I12 I13 I18 (search for similar items in EconPapers)
Date: 2019
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Citations: View citations in EconPapers (1)

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DOI: 10.1007/s10198-019-01046-1

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