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

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  • Gundula Krack

    (Ludwig-Maximilians University
    HelmholtzZentrum München)

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

Suggested Citation

  • Gundula Krack, 2019. "How to make value-based health insurance designs more effective? A systematic review and meta-analysis," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 20(6), pages 841-856, August.
    • Handle: RePEc:spr:eujhec:v:20:y:2019:i:6:d:10.1007_s10198-019-01046-1
    DOI: 10.1007/s10198-019-01046-1
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    Cited by:

    1. Jonathan Gruber & Johanna Catherine Maclean & Bill Wright & Eric Wilkinson & Kevin G. Volpp, 2020. "The effect of increased cost‐sharing on low‐value service use," Health Economics, John Wiley & Sons, Ltd., vol. 29(10), pages 1180-1201, October.

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    More about this item

    Keywords

    Value-based health insurance design; Health insurance; Cost sharing; Adherence; Meta-analysis;
    All these keywords.

    JEL classification:

    • D81 - Microeconomics - - Information, Knowledge, and Uncertainty - - - Criteria for Decision-Making under Risk and Uncertainty
    • H75 - Public Economics - - State and Local Government; Intergovernmental Relations - - - State and Local Government: Health, Education, and Welfare
    • I13 - Health, Education, and Welfare - - Health - - - Health Insurance, Public and Private
    • I12 - Health, Education, and Welfare - - Health - - - Health Behavior
    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health

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