Health Inc.

Chopping Copays Makes Medicines More Attractive

If a prescription medicine covered by your insurance plan is necessary for your health, why do you have to bother reaching into your wallet for a share of the cost?

University of Michigan/YouTube

Dr. A. Mark Fendrick, a proponent of value-based insurance, explains the ideas behind it.

Insurers, employers and pharmacy benefits managers have made picking a drug something of an obstacle course, with various tiers of copays in place to steer you toward one medicine or another.

Maybe it's no surprise, especially in these tough times, that requiring patients to fork over even a few bucks can keep them from taking medicines, such as blood pressure pills, that could prevent big health problems and expenses down the road.

So what would happen if you eliminated or really whacked the copays for drugs that can really make a difference in people's health? Well, as postage-meter maker Pitney Bowes found out, it helps.

The company eliminated the copay for statins, the cholesterol-fighting drugs that include Lipitor and simivastatin, for people with diabetes or cardiovascular disease. Those conditions put people at high risk for heart trouble and make statins a better value.

The company also dropped the copay for Plavix, or clopidogrel, a drug to prevent blood clots.

Both medicines are taken chronically and, for the right patients, have been shown to help prevent serious and costly illnesses.

By removing the copays, which averaged about $24 a month for the statins and $17 for the Plavix, the company was able to raise the number of days the drugs were taken by about 3 percent for statins and 4 percent for Plavix.

The improvements in adherence to prescriptions seem modest. But they're big enough for the authors of the paper, published in the latest issue of the policy journal Health Affairs, to conclude that the "findings support the adoption of this strategy" by lots of other insurers and companies.

Still, the authors concede that broader use of the approach still needs its cost-effectiveness to be "conclusively established.

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