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Utilization of smoking cessation medication benefits among medicaid fee-for-service enrollees 1999–2008

OBJECTIVE: To assess state coverage and utilization of Medicaid smoking cessation medication benefits among fee-for-service enrollees who smoked cigarettes. METHODS: We used the linked National Health Interview Survey (survey years 1995, 1997–2005) and the Medicaid Analytic eXtract files (1999–2008)...

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Autores principales: Kahende, Jennifer, Malarcher, Ann, England, Lucinda, Zhang, Lei, Mowery, Paul, Xu, Xin, Sevilimedu, Varadan, Rolle, Italia
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5313220/
https://www.ncbi.nlm.nih.gov/pubmed/28207744
http://dx.doi.org/10.1371/journal.pone.0170381
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author Kahende, Jennifer
Malarcher, Ann
England, Lucinda
Zhang, Lei
Mowery, Paul
Xu, Xin
Sevilimedu, Varadan
Rolle, Italia
author_facet Kahende, Jennifer
Malarcher, Ann
England, Lucinda
Zhang, Lei
Mowery, Paul
Xu, Xin
Sevilimedu, Varadan
Rolle, Italia
author_sort Kahende, Jennifer
collection PubMed
description OBJECTIVE: To assess state coverage and utilization of Medicaid smoking cessation medication benefits among fee-for-service enrollees who smoked cigarettes. METHODS: We used the linked National Health Interview Survey (survey years 1995, 1997–2005) and the Medicaid Analytic eXtract files (1999–2008) to assess utilization of smoking cessation medication benefits among 5,982 cigarette smokers aged 18–64 years enrolled in Medicaid fee-for-service whose state Medicaid insurance covered at least one cessation medication. We excluded visits during pregnancy, and those covered by managed care or under dual enrollment (Medicaid and Medicare). Multivariate logistic regression was used to determine correlates of cessation medication benefit utilization among Medicaid fee-for-service enrollees, including measures of drug coverage (comprehensive cessation medication coverage, number of medications in state benefit, varenicline coverage), individual-level demographics at NHIS interview, age at Medicaid enrollment, and state-level cigarette excise taxes, statewide smoke-free laws, and per-capita tobacco control funding. RESULTS: In 1999, the percent of smokers with ≥1 medication claims was 5.7% in the 30 states that covered at least one Food and Drug Administration (FDA)-approved cessation medication; this increased to 9.9% in 2008 in the 44 states that covered at least one FDA-approved medication (p<0.01). Cessation medication utilization was greater among older individuals (≥ 25 years), females, non-Hispanic whites, and those with higher educational attainment. Comprehensive coverage, the number of smoking cessation medications covered and varenicline coverage were all positively associated with utilization; cigarette excise tax and per-capita tobacco control funding were also positively associated with utilization. CONCLUSIONS: Utilization of medication benefits among fee-for-service Medicaid enrollees increased from 1999–2008 and varied by individual and state-level characteristics. Given that the Affordable Care Act bars state Medicaid programs from excluding any FDA-approved cessation medications from coverage as of January 2014, monitoring Medicaid cessation medication claims may be beneficial for informing efforts to increase utilization and maximize smoking cessation.
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spelling pubmed-53132202017-03-03 Utilization of smoking cessation medication benefits among medicaid fee-for-service enrollees 1999–2008 Kahende, Jennifer Malarcher, Ann England, Lucinda Zhang, Lei Mowery, Paul Xu, Xin Sevilimedu, Varadan Rolle, Italia PLoS One Research Article OBJECTIVE: To assess state coverage and utilization of Medicaid smoking cessation medication benefits among fee-for-service enrollees who smoked cigarettes. METHODS: We used the linked National Health Interview Survey (survey years 1995, 1997–2005) and the Medicaid Analytic eXtract files (1999–2008) to assess utilization of smoking cessation medication benefits among 5,982 cigarette smokers aged 18–64 years enrolled in Medicaid fee-for-service whose state Medicaid insurance covered at least one cessation medication. We excluded visits during pregnancy, and those covered by managed care or under dual enrollment (Medicaid and Medicare). Multivariate logistic regression was used to determine correlates of cessation medication benefit utilization among Medicaid fee-for-service enrollees, including measures of drug coverage (comprehensive cessation medication coverage, number of medications in state benefit, varenicline coverage), individual-level demographics at NHIS interview, age at Medicaid enrollment, and state-level cigarette excise taxes, statewide smoke-free laws, and per-capita tobacco control funding. RESULTS: In 1999, the percent of smokers with ≥1 medication claims was 5.7% in the 30 states that covered at least one Food and Drug Administration (FDA)-approved cessation medication; this increased to 9.9% in 2008 in the 44 states that covered at least one FDA-approved medication (p<0.01). Cessation medication utilization was greater among older individuals (≥ 25 years), females, non-Hispanic whites, and those with higher educational attainment. Comprehensive coverage, the number of smoking cessation medications covered and varenicline coverage were all positively associated with utilization; cigarette excise tax and per-capita tobacco control funding were also positively associated with utilization. CONCLUSIONS: Utilization of medication benefits among fee-for-service Medicaid enrollees increased from 1999–2008 and varied by individual and state-level characteristics. Given that the Affordable Care Act bars state Medicaid programs from excluding any FDA-approved cessation medications from coverage as of January 2014, monitoring Medicaid cessation medication claims may be beneficial for informing efforts to increase utilization and maximize smoking cessation. Public Library of Science 2017-02-16 /pmc/articles/PMC5313220/ /pubmed/28207744 http://dx.doi.org/10.1371/journal.pone.0170381 Text en https://creativecommons.org/publicdomain/zero/1.0/ This is an open access article, free of all copyright, and may be freely reproduced, distributed, transmitted, modified, built upon, or otherwise used by anyone for any lawful purpose. The work is made available under the Creative Commons CC0 (https://creativecommons.org/publicdomain/zero/1.0/) public domain dedication.
spellingShingle Research Article
Kahende, Jennifer
Malarcher, Ann
England, Lucinda
Zhang, Lei
Mowery, Paul
Xu, Xin
Sevilimedu, Varadan
Rolle, Italia
Utilization of smoking cessation medication benefits among medicaid fee-for-service enrollees 1999–2008
title Utilization of smoking cessation medication benefits among medicaid fee-for-service enrollees 1999–2008
title_full Utilization of smoking cessation medication benefits among medicaid fee-for-service enrollees 1999–2008
title_fullStr Utilization of smoking cessation medication benefits among medicaid fee-for-service enrollees 1999–2008
title_full_unstemmed Utilization of smoking cessation medication benefits among medicaid fee-for-service enrollees 1999–2008
title_short Utilization of smoking cessation medication benefits among medicaid fee-for-service enrollees 1999–2008
title_sort utilization of smoking cessation medication benefits among medicaid fee-for-service enrollees 1999–2008
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5313220/
https://www.ncbi.nlm.nih.gov/pubmed/28207744
http://dx.doi.org/10.1371/journal.pone.0170381
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