Supplementary materials: Impact of comparative effectiveness research on Medicare coverage of direct oral anticoagulants

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posted on 2024-05-03, 10:58 authored by Prachi Arora, Maria Muehrcke, Molly Russell, Rasitha Jayasekare

These are peer-reviewed supplementary materials for the article 'Impact of comparative effectiveness research on Medicare coverage of direct oral anticoagulants' published in the Journal of Comparative Effectiveness Research.

Appendix 1: Summary of the key characteristics of the included studies (n=39)
Appendix 2: Change points identified for the five outcome variables using Binary Segmentation change point analysis for dabigatran, rivaroxaban and apixaban.
Appendix 3: CPA plot displaying the percentage of the Medicare plans covering each DOAC with quantity limit from 2011-2017.
Appendix 4: CPA plot displaying the percentage of the Medicare plans covering each DOAC under prior authorization from 2011-2017.
Appendix 5: CPA plots displaying the percentage of the Medicare plans covering each DOAC with type of cost sharing at preferred pharmacies (0= not offered, 1= copay, 2= coinsurance) from 2011-2017.
Appendix 6: CPA plot displaying the mean percentages of coinsurance (i.e. type of cost sharing) at preferred pharmacies for each DOAC from 2011-2017.

Aim: To evaluate the association of comparative effectiveness research with Medicare coverage of direct oral anticoagulants. Materials & methods: A literature review for direct oral anticoagulants was conducted from 2011 to 2017. Monthly prescription drug plan and formulary files (n = 28) were used to conduct change-point analysis and assess each outcome variable. Results: Up to 2013, studies showed that dabigatran was more effective than rivaroxaban. In 2015, apixaban was shown to be the safest and most effective drug in comparison with all direct oral anticoagulants. In 2016–2017, dabigatran and apixaban were shown to have similar efficacy. Approximately 75% of plans covered dabigatran under tier 3 until 2015. From 2011 to 2017, less than 30% of plans required prior authorizations, 50% imposed quantity limits and mean copayment was lowest for rivaroxaban. Conclusion: Consistent with comparative effectiveness research, Medicare plans covered apixaban more favorably and edoxaban less favorably. However, discrepancies in comparative effectiveness research translation were found for rivaroxaban and dabigatran.