Some workers who have a financial incentive to stop using brand-name prescription drugs simply stop taking their drugs.

Researchers at Express Scripts Inc., St. Louis, have published data supporting that conclusion in an analysis of claims data for one customer with 19,500 employees that offered a health account option and another customer with a health account option and 14,600 employees.

The employees in the health account plans did not get the same kind of education and care management support that members of traditional plans received, the Express Scripts researchers report.

About 36% of the employees at the bigger employer and 22% of the employees at the other employer enrolled in the health account plans, the researchers report.

The increase in deductibles and utilization decreases cut drug plan costs 62% at the bigger employer and 24% at the smaller employer, and health account holders at both employers cut use of brand-name medications by more than 13%, the researchers write.

But the researchers believe that some of those employees ended up doing without needed medications, because the plans reported no significant increase in use of generic drugs.

At the traditional plans, use of brand-name drugs held steady, but use of generic drugs increased, the researchers report.

Total prescription use may have fallen at the health account plans partly because members began using new, over-the-counter versions of anti-ulcer drugs, but researchers should do more studies to see whether the decrease in utilization is affecting health plan members’ health, the researchers conclude.