Evaluation of increased adherence and cost savings of an employer value-based benefits program targeting generic antihyperlipidemic and antidiabetic medications.

@article{Clark2014EvaluationOI,
  title={Evaluation of increased adherence and cost savings of an employer value-based benefits program targeting generic antihyperlipidemic and antidiabetic medications.},
  author={Bobby L Clark and Janeen Duchane and John G. Hou and Elan Rubinstein and Jennifer L McMurray and Ian Duncan},
  journal={Journal of managed care pharmacy : JMCP},
  year={2014},
  volume={20 2},
  pages={
          141-50
        }
}
BACKGROUND A major employer implemented a change to its employee health benefits program to allow beneficiaries with diabetes or high cholesterol to obtain preselected generic antidiabetic or generic antihyperlipidemic medications with a zero dollar copayment. To receive this benefit, plan beneficiaries were required to participate in a contracted vendor's case management and/or wellness program.  OBJECTIVE To assess changes in medication adherence and the costs for generic antidiabetic and… 

Figures and Tables from this paper

Value-Based Insurance Design Improves Medication Adherence Without An Increase In Total Health Care Spending.
TLDR
Moderate-quality evidence showing improvement in medication adherence with VBID was found, and an increase in adherence was associated with no effect on total health care spending, which suggests that the incremental drug spending was offset by decreases in spending for other health care services.
The Effect of Zero Copayments on Medication Adherence in a Community Pharmacy Setting
TLDR
Overall, patients with $0 copayments had higher adherence rates than patients withCopayments greater than $0.
Do interventions that address patient cost-sharing improve adherence to prescription drugs? A systematic review of recently published studies
TLDR
A systematic review examines interventions that address patient cost-sharing to improve adherence to prescription drugs and reduce costs of care, finding that value-based financial incentive models have the potential to be a part of this effort.
Cost-sharing and adherence, clinical outcomes, health care utilization, and costs: A systematic literature review.
TLDR
The published literature shows consistent impacts of higher cost sharing on initiation and continuation of medications, and the greater the cost-sharing, the worse the medication adherence.
Capsule Commentary on Duru et al., Adherence to Metformin, Statins, and ACE/ARBs Within the Diabetes Health Plan (DHP)
  • R. McQueen
  • Medicine
    Journal of General Internal Medicine
  • 2015
TLDR
There was a modest improvement in adherence to the three DHP-covered medications after 1 year, and the DHP provided enrolled participants discounted copayments for medications and provider visits, and access to online or telephone wellness coaching.
How to make value-based health insurance designs more effective? A systematic review and meta-analysis
  • G. Krack
  • Medicine
    The European Journal of Health Economics
  • 2019
TLDR
It is concluded that VBID implementation should be encouraged, especially for patients with heart diseases, and that full coverage was associated with higher effects, which were robust in most sensitivity analyses.
Employer-Led Strategies to Improve the Value of Health Spending: A Systematic Review
TLDR
The most promising efforts in employer-led efforts to improve the value of health spending in the United States were those that lowered or eliminated cost sharing for primary care or medications for chronic illnesses.
Effects of the Chronic Disease Self-Management Program on medication adherence among older adults.
TLDR
The long-term impacts of the CDSMP on medication adherence were influenced by the short-term program impacts on health-related indicators, including medication adherence, self-rated health, depression, and patient communication skills.
Adherence to the American Diabetes Association retinal screening guidelines for population with diabetes in the United States
TLDR
Pat socioeconomic status, younger age, black race, lower income/education, less comorbidity, insulin use, higher specialist copayment plans, and proxies for poor patient behavior were associated with nonadherence to routine eye screening exams.
...
...

References

SHOWING 1-10 OF 44 REFERENCES
Medication adherence changes following value-based insurance design.
OBJECTIVES To determine whether participation in a value-based insurance design (VBID) program was associated with improved medication adherence in 8 drug classes 2 years after implementation and to
The Effect of a Large Regional Health Plan’s Value-based Insurance Design Program on Statin Use
TLDR
Copayment reductions on selected statin medications contributed to improvements in adherence and demonstrate that insurer-based VBID programs may yield results similar to those achieved by employer-based programs.
The effects of prescription drug copayments on statin adherence.
TLDR
High copayments are a financial barrier to statin adherence and the index copayment amount can affect compliance with statin use, which should be considered by policy makers.
The impact of value-based benefit design on adherence to diabetes medications: a propensity score-weighted difference in difference evaluation.
TLDR
A VBBD program that reduced the copayment for diabetes medications by 36.1% reduced the number of nonadherent patients by 30.0% andensity score-weighted DID analysis showed that patients withCopayment reduction had greater odds of being adherent.
Impact of statin copayments on adherence and medical care utilization and expenditures.
TLDR
Lower statin copayments were associated with higher levels of statin adherence and policy makers and plan managers should consider interventions that improve adherence to statins, such as lowerCopayments.
Clinical outcomes and adherence to medications measured by claims data in patients with diabetes.
TLDR
Claims-based measures of medication adherence are associated with clinical outcomes in patients with diabetes and may therefore prove to be useful in clinical practice and more research is needed on methods to introduce claims-based adherence measurements into routine clinical practice.
A value-based insurance design program at a large company boosted medication adherence for employees with chronic illnesses.
TLDR
In a retrospective, observational study of employees of a large global pharmaceutical firm, how reduced patient cost sharing for prescription drugs for asthma, hypertension, and diabetes affected the use of these drugs and related medical services is evaluated.
Comparing adherence and persistence across 6 chronic medication classes.
TLDR
A retrospective analysis of pharmacy claims in a database of more than 64 million members enrolled in 100 health plans assessed persistence and adherence to drug therapy in 6 chronic conditions found variable but uniformly suboptimal medication use.
Impact of a Prescription Copayment Increase on Lipid-Lowering Medication Adherence in Veterans
TLDR
The copayment increase adversely affected lipid-lowering medication adherence among veterans, including those at high coronary heart disease risk.
Analysis of factors associated with statin adherence in a hierarchical model considering physician, pharmacy, patient, and prescription characteristics.
TLDR
Because of the variability in adherence rates across pharmacies and physicians, further assessment of pharmacy and physician characteristics in addition to patient characteristics may be of value in improving adherence.
...
...