Lowering co-pays improves medication adherence

Insurance plans that reduced or eliminated co-payments for medications have seen an increase in the number of people following their prescriptions, according to two studies published in Health Affairs. Researchers were specifically interested in so-called value-based insurance design, which reduces co-pays for meds and services that provide a lot of bang for the buck, the Wall Street Journal explained.

In the first study, the self-insured firm Pitney Bowes eliminated co-payments for cholesterol-lowering statins like Lipitor and increased employee adherence to the drugs by 2.8 percent. The company also reduced co-payments for the blood-clot inhibitor Plavix and adherence climbed 4 percent. The co-pays averaged about $24 a month for the statins and $17 for the Plavix, according to NPR’s Shots health blog.

The second study demonstrated similar results. Adherence to prescriptions for BlueCross BlueShield in North Carolina enrollees with diabetes, hypertension, hyperlipidemia and congestive heart failure increased between 1.5 percent and 3.8 percent when patients paid less than employees who weren't offered the option, The Hill’s Healthwatch reports.

"If these promising early results are validated in other settings," the study authors write, "the trend of rising co-payments may be replaced with a long-term trend of decreasing or vanishing co-payments."

However, they note that, thus far, "there is very limited evidence of the impact of the design on healthcare use and spending."

The authors also say other variations on co-pay might help adherence--for example, lowering co-pays for people who show better adherence, notes the WSJ.

To learn more:
- read the Wall Street Journal article
- see The Hill’s Healthwatch story
- read NPR’s Shots health blog post

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