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.
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
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 resu
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