A study by CVS Caremark (NYSE: CVS), published this week in the American Journal of Pharmacy Benefits, finds that insurance benefit designs that reduce the cost of medications for plan participants result in patients being more likely to start and stay on their medication therapy.
The study compared more than 20,000 plan participants in value-based insurance design (VBID) plans to more than 190,000 participants of similar age and gender breakdowns in standard three-tier plans. The study concluded initiation and adherence rates for both insulin and oral diabetes medicines among participants in value-based plans were significantly higher.
"There have been discussions around the impact of price and affordability on patients' ability and willingness to start and stay on their medications and this research adds to that body of knowledge. We took a look at one disease state – diabetes – and showed how cost impacts a patient's prescription initiation and adherence rates," said Troyen A. Brennan, M.D., M.P.H., Executive Vice President and Chief Medical Officer, CVS Caremark. "This research is important as we seek to educate the public and patients that adherence can be the most cost effective intervention in health care."
In the VBID plans studied, generic co-pays were reduced from $15 to zero, preferred brands dropped to between $10 and $15 from $30, and non-preferred brands remained at $35 co-pay, compared with standard plans which had no changes in co-pays during the study period. Participants in VBID plans had higher prescription initiation rates (2.3% versus 1.6% on the total study population) and lower discontinuation rates (16% versus 24.3%).
This study is part of a broader research effort by CVS Caremark to learn more about why patients do not take prescriptions that are prescribed, or drop the medications in the middle of therapy. The research includes continuing internal analysis of CVS Caremark clients and an external partnership with Harvard and Brigham & Women's Hospital. Separately, a recent study by the New England Healthcare Institute found that not taking medications as prescribed leads to poorer health, more frequent hospitalization, a higher risk of death and as much as $290 billion annually in increased medical costs.
The research findings will be used to develop programs that aim to improve patient education about the importance of adherence, and communications for timely interventions with patients that include face-to-face first fill counseling; IVR and Web refill reminders, renewals and pick-up prompts; and outreach calls to potentially non-adherent patients from their local CVS pharmacist.
"As the health care debate continues, one thing is clear: We all have to find ways to make health care more affordable," Brennan said. "Our passion and expertise is to help our clients receive the best pharmacy care available, and that can be achieved by focusing on adherence to impact the health of our customers and help take costs out of the health care system," Brennan said.
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