Zero copay program achieves better patient adherence

Employees enrolled in a zero copay program for their diabetes and high cholesterol drugs had better adherence to those medications than employees not enrolled in the program, according to a recent retrospective case comparison study from Walgreens.

The Walgreens study examined an employer-based value-based insurance design program implemented in January 2010, which eliminated the copay for generic anti-diabetic and anti-hyperlipidemic (cholesterol) medications. Eligible members (diabetic and/or high-cholesterol beneficiaries) were required to participate in a case management or wellness program to receive the zero copay benefit.

About 4,100 beneficiaries enrolled, while almost 22,000 elected not to. Among those that enrolled, 3,400 had diabetes and high cholesterol, compared to 2,400 of the non-enrolled. Both the enrolled diabetic and high cholesterol populations had higher adherence. The diabetic group’s adherence rate was 70% compared to about 45% for those not enrolled; the high cholesterol group’s adherence rate was about 66% vs. 55% for those not enrolled.

“With what we were seeing in the market, with the success of these value-based benefits designs, we wanted to provide that financial incentive for individuals to become more engaged with their condition, when it comes to talking a the health coach,” says Jennifer P. McMurray, PharmD, director, health care products and services with Walgreens. “In order to do that, we felt that financially rewarding them with a zero copay for these medications would be a great way to engage.”

The study also showed a slightly higher switch rate to generic medications for those enrolled in the zero copay program.

“Not only are people seeking out generic medications for the medications of cholesterol and diabetes, because that where you can get your zero copay, but we're also seeing across individuals' medication profile -- even in other conditions -- them seeking out generic medication for other medications they might be taking,” says McMurray.

To qualify for the zero copay program, plan members had to speak with a health coach at least five times.

“I think the key takeaways are that employers should try to reach out to those employees who are in greatest need for whatever program they offer,” says Dr. Bobby L. Clark, PhD, MSPharm, Walgreens director of clinical outcomes and reporting. “For example, for our particular program, in order to do the greatest good, we need to try to enroll those who are sickest, as determined by the number of comorbidities they may have.”

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