Influences on consumer spending for herbal products

BACKGROUND

Despite the rapid growth in consumer spending on herbal products, we know little about factors that influence such spending.

OBJECTIVE

To use a model of adoption to investigate consumers' spending on herbal products.

METHODS

The study used a mail survey of a stratified random sample of 1,300 consumers. The population consisted of consumers aged 18 years and older residing in the United States. The sampling frame was a mailing list purchased from KM Lists. The independent variables were consumer characteristics, social systems, communication channels, and herbal characteristics. The amount of spending on herbs was the dependent measure, with responses divided into monthly spending of 10 dollars or less and more than 10 dollars . Binary logistic regression was performed to investigate the association between adoption model variables and spending on herbs.

RESULTS

Of the 1,300 mailed surveys, there were 77 undeliverable surveys and 456 usable returned surveys, yielding a usable response rate of 37.3%. A total of 181 (39.7%) respondents reported using herbal products. The logistic regression was performed using the 168 herbal users who reported that they spent money in the past month on herbal products. The overall regression model was significant (P<.05, Nagelkerke R(2)=0.499). The significant influences on spending on herbals were age, over-the-counter (OTC) drug use, and use of an herb professional as an information source about herbs. Older people reported spending more on herbal products than younger people. OTC drug use was positively related to spending on herbals and appears to complement herbal usage. Finally, consumers who obtain information about herbals from an herb professional tend to spend more on herbals.

CONCLUSION

An adoption model may be useful in explaining consumers' spending on herbal products.

Iowa medicare beneficiaries' satisfaction and experiences with a prescription drug discount card and preferred drug list

OBJECTIVE

To evaluate the expectations, experiences, and satisfaction with the Iowa Priority Prescription Savings (IPPS) program.

DESIGN

Longitudinal descriptive study.

SETTING

Iowa.

PARTICIPANTS

Randomly selected Iowa Medicare beneficiaries who self-enrolled in the IPPS prescription discount card program.

INTERVENTIONS

Three self-administered surveys mailed in November 2002, June 2003, and September 2004, during the first, second, and third years of IPPS operation.

MAIN OUTCOME MEASURES

Expectations of drug discounts, amount of discounts received, awareness of the IPPS preferred drug list (PDL), and satisfaction with the program.

RESULTS

Usable response rates for the three surveys were 43.5%, 31.0%, and 38.4%. About one fourth of members initially expected discounts of more than 20% on their prescription medications. After IPPS was implemented, many members were unaware of the discounts they were receiving, but the percentage of members reporting discounts of more than $20 per month increased from 7.4% in year 1 to 16.4% in year 3. More than one half of the members were unaware of which drugs were on the PDL in years 1 and 2, but this improved to 21% unawareness in year 3. Satisfaction with the program was low but improved over time. Members who received discounts, did not expect large discounts, or received a medication review were more satisfied with the program.

CONCLUSION

Some IPPS members had unrealistic expectations about the amount of discounts they would receive, and expectations of large discounts decreased satisfaction. Satisfaction and amount of discounts improved over time, and beneficiaries whose medications were reviewed, usually by a pharmacist, were more satisfied with the program. PDL awareness was a problem despite substantial educational efforts by IPPS, a finding that has implications for the recently implemented Medicare Part D drug benefit.

Population-based medication reviews: a descriptive analysis of the medication issues identified in a medicare not-for-profit prescription discount program

BACKGROUND

Medication reviews may be an important strategy to improve medication use, especially for individuals receiving many drugs.

OBJECTIVE

To describe the types of medication issues and recommendations identified in the Iowa Priority Brown Bag Medication Reviews, compare individuals with medication issues with those without medication issues, and describe Iowa Priority enrollees' experiences with and satisfaction of the review.

METHODS

A retrospective review of enrollment forms and medication review records and a survey of Iowa Priority members were conducted in 2002. Subjects were Medicare-eligible individuals who joined the Iowa Priority Prescription Savings Program. Frequency distributions and descriptive statistics were calculated. Analysis using t-test and chi(2) test determined differences between individuals with and without issues regarding use of drug therapy.

RESULTS

Almost 13% of Iowa Priority enrollees received a review. There were 1167 individuals with 2123 medication issues identified. Nonprescription medications accounted for one-third of drug interactions and >40% of duplications. People with issues had poorer health, more chronic conditions, and took more drugs than people without medication issues. One-third of survey respondents discussed the review with their physicians, and 17.7% reported medication changes. Satisfaction with the review was good; however, only 24% were likely to have received an annual review.

CONCLUSIONS

Iowa Priority Brown Bag Medication Reviews showed that individuals with fair/poor health, higher numbers of medications, and more chronic conditions were likely to have medication issues. Reviews generated discussions between physicians and patients, produced some medication changes, and helped individuals save money.

Consumer attitudes and factors related to prescription switching decisions in multitier copayment drug benefit plans

OBJECTIVES

To examine patient attitudes related to formulary medications and medication-related decision making in multitier copayment prescription drug plans.

STUDY DESIGN

A cross-sectional retrospective analysis.

METHODS

Data were collected via mail survey from a random sample of 25,008 members of a managed care organization. The selected members were enrolled in a variety of 2- and 3-tier copayment plans and were taking prescription medication to treat 1 or more of 5 chronic disease states.

RESULTS

Most respondents did not believe that formulary drugs were safer or more effective than nonformulary drugs, but 39.7% thought that formulary drugs were relatively less expensive. Most respondents appeared willing to consider switching from a nonformulary drug to a formulary drug with a lower copayment. The percent of respondents who reported they would be very unlikely or unlikely to switch was only 15.3% for a new prescription and 24.2% for a refill prescription. Medication efficacy and physician opinion were important factors in plan members' switching decisions. Cost was an important factor for some members, but older plan members were less likely to report that cost was important.

CONCLUSIONS

Multitier plan members generally believed that drugs are placed on the formulary for reasons of cost rather than safety or efficacy. Most plan members were receptive to switching from a nonformulary to a formulary medication, but financial incentives alone may not convince some plan members to make the switch.