CVS study: Lower co-pays = higher adherence
WOONSOCKET, R.I. —Lowering generic co-payments isn’t just a good way to increase generic utilization, it also can improve patient adherence. That’s according to a recently released study by CVS Caremark.
“Our 2009 Benefit Planning Survey found that clients are more interested in identifying opportunities to change plan participant behavior, rather than shift costs,” stated Jack Bruner, EVP of CVS Caremark. “The data presented at [the Academy of Management Care Pharmacy Annual Educational Conference] illustrates an example of how we can work with our plan sponsors to change and optimize participant behavior in order to achieve increased generic utilization. These types of partnerships enable us to effectively reduce costs for both our client and their plan participants without compromising quality or access.”
The study, which included 15,000 plan participants covered by a self-funded employer group who were continuously enrolled under the benefit between Dec. 1, 2007, and July 31, underscored how PBMs can work with plan sponsors to manage costs and improve health outcomes by changing plan participant behavior, CVS stated. By implementing a $0 co-pay structure for generic medications, the generic dispensing rate increased to 60.8% (a 4.2% increase) during the study period.
In addition to an improved generic dispensing rate, the analysis found that the average participant cost share for generic drugs decreased 9.4%. The average plan cost per 30 days of therapy also exhibited a slight decline, despite the reduction in generic co-payment rates. Prevalence of use in three key preventative drug classes increased significantly—participants on cholesterol-lowering therapy increased 13%, those on antihypertensive therapy increased 7% and those on diabetic therapy increased 9%—as a proportion of eligible patients.
“In addition, the data indicates that lowering generic co-payment may also be associated with an increase in participants taking key preventative drugs, which could positively impact adherence and overall health incomes,” Bruner added.
Nonadherence has been widely recognized as a major public health problem, according to prior research cited in numerous medical journals. Nonadherence to essential medications is a frequent cause of preventable hospitalizations and patient illness, with costs to the U.S. healthcare system estimated at more than $200 billion annually.
To address this public health concern, CVS is embarking on another initiative. Through a research agreement, CVS is working with faculty from Brigham and Women’s Hospital, Harvard Medical School and Harvard Faculty of Arts and Sciences to develop an interdisciplinary initiative to improve medication use. This approach allows experts in such disciplines as psychology, sociology and political studies to bring their expertise about patient behavior and healthcare policy to bear.
The multiyear study has four key components:
Determine causes and scope of abandoned prescriptions
Drive adherence through simplification and consolidation
Evaluate the clinical and financial value of adherence incentives
Determine how e-prescribing impacts costs, compliance and safety.
“This research, which will be available not only to CVS affiliates but to all pharmacies, will help doctors, pharmacies, hospitals and health plans design programs to help patients stay on their prescribed medication treatments,” stated Troyen Brennen, EVP and chief medical officer for CVS Caremark, in announcing the news earlier this month.