Medication Adherence Increases with V-BID

Jeff Elliott, for HealthLeaders Media, November 8, 2010

Lower insurance copays for high-value chronic illness medications leads to a greater utilization by patients, according to two studies recently published in Health Affairs.

A group from Harvard Medical School analyzed efforts by Pitney Bowes. The corporation provides health insurance directly to employees and and incites employees to adhere to their high-value medication regimen by eliminating co-pays. Findings of the study indicate that compliance increased by 2.8% for individuals taking cholesterol-lowering statins and 4% for those on a blood-clot inhibitor.

Another study conducted by Blue Cross Blue Shield of North Carolina has found that there is an increase in medication adherence—between 1.5% and 3.8%—for plan members that paid less for diabetes, hypertension, and congestive heart failure drugs.

The concept, called value-based insurance design (V-BID), is intended to align patients' out-of-pocket costs, including co-pays and premiums, with the value of the health service, V-BID designers Dr. A. Mark Fendrick, Dr. Dean Smith and Dr. Michael Chernew at the University of Michigan say.

"Our evidence has clearly shown that when health plans and payers have increased patient cost sharing, there has been a reduction in use of nonessential services as well a essential services such as cancer screenings, office visits and high-value prescription drugs," says Fendrick, professor in the Department of Internal Medicine at the University of Michigan and co-director of its Center for Value-Based Insurance Design.

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