UPMC Health Plan is expanding its medication adherence program with Sempre Health to include diabetes medications.
The partnership, which first launched in 2017, uses text messages to remind members about medication refills and to provide point-of-sale discounts on included medications where appropriate. It is available to members in fully insured employer plans and self-ensured employer plans who do not choose to opt out.
The program initially focused on conditions such as cardiovascular disease, Chronis Manolis, chief pharmacy officer at UPMC, told Fierce Healthcare. In the first year, the program enrolled more than one-third of eligible members and led to significant improvements in adherence in comparison to a control group.
"If you think about the drugs we’ve chosen to date … they’re brands, they’re drugs that people can have a hard time affording, especially if you’re medically complex," Manolis said. "They’re drugs that if you are not adherent you can have bad medical outcomes rather soon."
Over the past three years, the program has saved members more than $500,000, with the average member saving $33 per prescription refill.
National data suggest as many as a third of Americans fail to take medications as prescribed due to cost. Under the joint program, members are rewarded with discounts on copayments when they fill prescriptions on time.
Manolis said the texts, refill reminders and rewards are a "trifecta of opportunity" to improve members' care
Anurati Mathur, CEO Of Sempre Health, told Fierce Healthcare that the program with UPMC has very high enrollment in comparison to other programs the company is involved in.
She said that the program has developed unique appeal in the COVID-19 era, as it cuts down the encounters necessary to secure a prescription fill and also allows for personalized, direct communication with members in a time when many are feeling especially isolated.
"I think Sempre, using text message, is bridging some of those gaps we do see more and more meaningfully in this moment," Mathur said.
Manolis said it made sense to expand into diabetes as it's a common condition that leads to significant cost to the system, with a slew of innovative new drugs and therapies that may be out of reach for members who would benefit.
Diabetic patients also frequently face complex comorbidities that can exacerbate their condition if their diabetes isn't managed appropriately, he added.
"We wanted to make a big splash," he said. "To do this for all of our diabetic population was really one of our goals."