CVS Health study finds broader Rx drug coverage improves health outcomes

WOONSOCKET, R.I. — A new analysis by researchers at Brigham and Women's Hospital and the CVS Health Research Institute, published on-line first in the American Journal of Public Health, shows that enhanced prescription drug insurance can improve patient health outcomes and reduce use of other (often costly) healthcare services.



"This review confirms the central role that effective prescription drug insurance can play as policymakers seek mechanisms to reduce rising health care costs in the United States," saidTroyen Brennan, chief medical officer, CVS Health and a study author. "Our analysis indicates that while expanding insurance benefits may lead to initial cost increases, these costs should be offset by future reductions in spending associated with preventable patient morbidity and mortality."



The authors conducted a review of 23 studies that investigated prescription drug insurance changes between 1990 and 2013 and reported on associated healthcare use and patient health outcomes. Patients with government-sponsored drug insurance were the primary population studied. Across the reviewed research studies, the authors observed a consistent link between drug insurance and improved patient health status. For example, when drug insurance programs were enhanced or expanded, more patients were able to afford important medications enabling them to access and adhere to prescription medicines for chronic conditions. This in turn decreased costly complications and overall healthcare use, including hospitalizations from unmanaged or under-managed conditions. Several studies also showed a negative impact on patient health outcomes when insurers placed burdensome caps on drug benefits.



"As we continue to work towards balancing cost and quality in the U.S. health care system, this analysis suggests that policymakers should consider strategies other than limiting drug insurance," added the study's lead author, Aaron Kesselheim, associate professor of medicine at Harvard Medical School and faculty member in the Division of Pharmacoepidemiology and Pharmacoeconomics, Brigham and Women's Hospital. "These could include strategies aimed at increasing the accessibility of essential prescription drugs, such as timely availability of generic alternatives and policies designed to improve medication adherence."



Many public and private insurers are taking steps to control rising health care costs. For example, some state Medicaid programs in recent years have enacted prescription drug restrictions by placing caps or limits on the number of prescriptions a patient can fill each month. The results of this systematic review of past studies suggests that restricting the availability of prescription drugs or prohibiting access could have collateral negative effects on patients' health and may not produce the expected cost-savings. They also suggest that economic calculations of Medicaid expansion have not taken into consideration the reduction in costs from the prevention of complications when millions of Americans previously without drug insurance are able to access important medicines to better manage chronic conditions.