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HCCI: Babies are using less prescription medicine

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Group health plan spending on children ages 0 to 18 increased a little faster than spending on adults between 2012 and 2013, according to the Health Care Cost Institute (HCCI).

Per-capita spending increased 4.6 percent for children over that period, to $2,575 per child, according to HCCI.

The insurer consortium found that per-capita spending on adults increased 3.9 percent over that same period, to $4,865.

See also: Health care costs [Infographic]

HCCI, an insurer consortium, used information from member insurers on what employer-sponsored plans actually paid for care for 10.2 million young enrollees.

Per-capita spending averaged $4,813 for babies ages 0 to 3; $1,703 for children ages 4 to 8; $1,854 for children ages 9 to 13; and $2,746 for children ages 14 to 18.

HCCI analysts found that plans and providers kept a tight leash on children’s use of health care services. Use of inpatient hospital services per 1,000 insured children increased only 0.5 percent, and use of outpatient services per 1,000 insured children fell 0.8 percent. 

Average prices for most covered services increased less than 7 percent. The one exception was brand-name prescription drugs. The average price per filled prescription increased about 22 percent, to $13, while the average price of a generic prescription increased 3.5 percent, to $2.

Overall pediatric use of prescription drugs per 1,000 children fell 1.3 percent, to 73,299 filled days. Use of generic prescriptions per 1,000 children rose 4.6 percent, to 57,338 filled days, but use of brand-name prescriptions per 1,000 children sank about 19 percent, to 15,798 filled days.

Cost pressure and changes in physician practices seem to have had an especially big effect on babies.

In the other age categories, use of generic drugs increased as use of brand-name drugs fell.

For babies, use of both brand-name and generic drugs fell. Babies’ use of brand-name drugs fell 17 percent, to 5,373 filled days per 1,000 insured babies. Their use of generic prescriptions fell 4.6 percent, to 38,439 filled days per 1,000 babies.

Major Patient Protection and Affordable Care Act (PPACA) benefit design changes started to take effect in the small-group market in 2014. The data for 2013 reflects how the market operated before those changes rolled in.

See also: Insurer think tank: radiologists not the villains


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