Navigation Links
New Study Indicates Decreasing Prescription Copayments Results in Increased Adherence for Patients with Chronic Diseases

Study published in Health Affairs highlights large employer's efforts to

develop a healthier workforce by removing barriers to treatment

PHILADELPHIA, Jan. 8 /PRNewswire-FirstCall/ -- Removing economic barriers to treatment for chronic conditions encourages patients to remain on recommended therapies according to a new study published today in the January/February 2008 issue of Health Affairs. The study, funded, in part, by GlaxoSmithKline (NYSE: GSK), investigated the impact on medication adherence of reducing prescription copayments -- in addition to existing disease management programs -- for employees of a leading service industry company.

Although a lack of medication adherence can be attributed to several factors,(1,2) the effects of high prescription drug copayments have been studied extensively since they have often been used by employers and insurers to control drug expenditures(3). Increasing copayments has been shown to decrease use of medications for chronic conditions.(4-6) But few studies have assessed the impact of decreasing copayments for important prescription medications.

The Impact of Decreasing Copayments on Medication Adherence in the Context of a Disease Management Program was a 12-month study in which the company, a global service provider, decreased copayments for the following medicines used to treat common chronic diseases:

-- Heart Disease: angiotensin converting enzyme (ACE) inhibitors,

angiotensin receptor blockers (ARBs), and beta-blockers

-- Diabetes: medications including oral therapies and insulin

-- High Cholesterol: statins

-- Asthma: inhaled corticosteroids

Copayment rates for generic medications were reduced from $5 to $0; copayments for branded drugs were cut in half. A similar employer with identical disease management offerings and similar but stable copayments served as a control group.

The study was coauthored by Michael E. Chernew, PhD (Harvard University); A. Mark Fendrick, MD and Allison B. Rosen, MD, ScD (University of Michigan); Mayur Shah, MA, Arnold Wegh, MS, Stephen Rosenberg, MD, MPH, and Iver A. Juster, MD (Active Health Management); and Michael C. Sokol, MD, MS and Kristina Yu-Isenberg, PhD, RPh (GSK). Doctors Fendrick, Rosen, and Chernew are members of the University of Michigan Center for Value-Based Insurance Design.

Key Findings

The study investigated the impact of lowering copayments both on the rates of adherence and non-adherence for selected chronic medications. Both adherence and non-adherence were determined based upon the ratio of eligible days each patient was in possession of his or her medicine.

Several key findings resulted:

-- There was a statistically significant improvement in adherence for

heart disease, diabetes, and high cholesterol.

-- The results were achieved in addition to the effects of existing

disease management programs.

-- Value based insurance design programs can effectively increase

adherence to important medications and complement existing disease

management programs.

There was a small positive result for inhaled corticosteroids for the treatment of asthma, which was not, however, statistically significant. The authors note that this finding reflects the difficulty of measuring adherence for this class of drugs -- there are multiple doses in a single inhaler as opposed to the other medication classes, which more readily allowed individual doses to be counted.

The current study complements the results of an earlier study from GSK's Health Management Innovations team, which indicated that increasing prescription copayments results in decreased medication adherence. These studies, taken together with the literature on medication adherence, suggest that value based benefits can lead to better adherence which may lead to better outcomes for both patients and employers.

"We saw in the earlier study the detrimental effect of increasing copayments on patient medication adherence. Now with this study, we are able to show that removing economic barriers to medication can positively affect patient behavior," said Michael C. Sokol, MD, MS, medical director for GSK's Health Management Innovations team.

Good Health is Good Business

More often than not, today's greatest healthcare problems are chronic conditions which require ongoing, patient-centered management. In fact, $3 of every $4 spent on healthcare in the US(7) goes to treating the 45% of Americans with at least one chronic disease.(8) As well, according to the Milken Institute, the seven most common chronic diseases cost the US economy $1 trillion each year -- including both direct and indirect costs. That figure is expected to reach $6 trillion each year by the middle of the century if unchecked.(9)

Poor adherence to a medication regimen is a serious problem, especially for those with chronic diseases, contributing to substantial worsening of disease, complications, death, and increased healthcare costs.(10) While employers have often implemented strategies of shifting costs onto the patient, this is only a short-term economic fix. To lower overall healthcare costs and improve the health of patients, the focus must be on the real problem -- chronic diseases.

"We must encourage patients to take medications as prescribed for these chronic conditions, and encourage employers to support the health management efforts of their workers," said Dr. Mark Fendrick. "As a nation, we must look at the healthcare continuum, focusing on prevention to keep people healthier, giving patients the right treatments to maintain their health, and continuing the search for new cures."

GSK's Health Management Innovations team is also analyzing the results of several other studies investigating potential factors affecting patient compliance, including assessing the impact of:

-- copayment level on specific outcomes such as Hba1c levels for diabetic


-- income on initial copayment levels and increases in copayment levels

-- implementing a consumer-directed health plan

-- implementing a pay-for-performance initiative

Formal results of these studies will be announced as they are published.

To hear more about this study, visit

About GlaxoSmithKline

GlaxoSmithKline, one of the world's leading research-based pharmaceutical and health care companies, is committed to improving the quality of human life by enabling people to do more, feel better, and live longer.

1. Haynes RB, Yao X, Degani A et al. Interventions to enhance medication adherence. Cochrane Database Syst Rev. 2005:CD000011.

2. McDonald HP, Garg AX, Haynes RB. Interventions to enhance patient adherence to medication prescriptions: scientific review. JAMA. 2002;288:2868-2879.

3. Kaiser Family Foundation and Health Research and Educational Trust. Annual Surveys of Employer-Sponsored Health Benefits, 2000-2005.

4. Gibson TB, Ozminkowski RJ, Goetzel RZ. The effects of prescription drug cost sharing: a review of the evidence. Am J Manag Care. 2005;11:730-740.

5. Lexchin J, Grootendorst P. Effects of prescription drug user fees on drug and health services use and on health status in vulnerable populations: a systematic review of the evidence. Int J Health Serv. 2004;34:101-122.

6. Goldman DP, Joyce GF, Escarce JJ et al. Pharmacy benefits and the use of drugs by the chronically ill. JAMA. 2004;291:2344-2350.

7. CDC, "Chronic Disease Overview: Costs of Chronic Disease," available at, accessed October 20, 2006.

8. American College of Physicians. "Costs and Quality Associated With Treating Medicare Patients With Multiple Chronic Diseases." Available at Accessed September 18, 2007.

9. Devol R and Bedroussian A. An Unhealthy America: The Economic Burden of Chronic Disease. Milken Institute. October 2007.

10. Osterberg L, Blaschke T. Adherence to medication. N Engl J Med. 2005;353:487-497.

SOURCE GlaxoSmithKline
Copyright©2008 PR Newswire.
All rights reserved

Related medicine news :

1. New Study: Screening for Problem Drinking is One of the Most Cost-Effective Clinical Preventive Services
2. New study: US ranks last among other industrialized nations on preventable deaths
3. Study proves the co-pay connection in chronic disease
4. Study Casts Doubt on Vaccine-Autism Link
5. Columbia Center for Childrens Environmental Health receives NIEHS grant to study asthma
6. Risk factors for Parkinsons disease under study
7. Patient-Centric Healthcare Study Reveals Key Insights for Pharmaceutical Marketers
8. Circumcision doesnt reduce sexual satisfaction and performance, says study of 4,500 men
9. Pollution shrinks fetus size: Brisbane study finds
10. Researchers use neuroimaging to study ESP
11. Study finds most TV prescription drug ads minimize risk information
Post Your Comments:
(Date:11/30/2015)... ... November 30, 2015 , ... Using a combination of two ... American children and adults, according to a new study by researchers at the School ... in Children and Adults: Using Combinations of Blood Glucose Tests ,” published in Frontiers ...
(Date:11/30/2015)... ... ... Newly reviewed and approved “NJ Top Dentist”, Dr. Eugene Isola III, is ... in 1935. His father graduated from NYU School of Dentistry in 1965. ... their commitment and passion to the Practice of Dentistry. Continuing the family practice ...
(Date:11/30/2015)... New York, NY (PRWEB) , ... November 30, 2015 , ... ... New York Times,” will be released on December 1, 2015, to coincide with World ... book about the groundbreaking journalist who covered the AIDS epidemic as he was dying ...
(Date:11/30/2015)... ... November 30, 2015 , ... The American Society for ... honor of World AIDS Day 2015. On Nov. 30, ASCP shared its “Give a ... about World AIDS Day and the importance of getting tested for HIV. , ASCP ...
(Date:11/30/2015)... ... 30, 2015 , ... California-based i2i Systems, a pioneer defining ... Michigan-based Family Health Center (FHC) has selected i2iTracks as their population health management ... the largest Affordable Care Act grant for Federally Qualified Health Centers in the ...
Breaking Medicine News(10 mins):
(Date:11/30/2015)... -- --> --> According ... Product (Soft Tissue, All Tissue, Dental Welding Lasers), Application (Conservative ... - Global Forecast to 2020", published by MarketsandMarkets, is expected ... of 5.2% during the forecast period from 2015 to 2020. ... Figures spread through 167 P ages and in-depth TOC ...
(Date:11/30/2015)... and ST. LOUIS , Nov. ... (NASDAQ: ESRX ) today announced an early renewal ... which began in 1999, will now extend through at ... --> After evaluating pharmacy benefit manager capabilities during ... Express Scripts continues to offer the best health plan ...
(Date:11/30/2015)... , Nov. 30, 2015 Booth #4303 – ... VAR ) will exhibit a broader array of products in ... Radiological Society of North America in ... at the meeting will feature X-ray components "At the Heart ... a line of products from Varian,s Claymount brand, and computer-aided ...
Breaking Medicine Technology: