Authors of two academic studies have found evidence that tweaking patients’ out-of-pocket costs can affect the likelihood that they will follow physicians’ orders.

The researchers published the articles, which feature the Pitney Bowes Inc. benefit plan and Blue Cross and Blue Shield of North Carolina, Chapel Hill, N.C., in Health Affairs, an academic journal that focuses on the delivery and financing of health care.

The researchers received grants from the California HealthCare Foundation, Oakland, Calif., which is backing studies that test the effectiveness of the “value-based insurance design” (VBID) concept.

VBID advocates recommend that insurers be more generous than usual when paying for preventive care that seems likely to reduce the overall cost of care.

Niteesh Choudhry of Harvard University and colleagues looked at a move by Pitney Bowes, Stamford, Conn., to eliminate co-payments for cholesterol-lowering statins and to reduce co-payments for the blood clot inhibitor clopidogrel.

The moves increased statin adherence 2.8% and clot inhibitor adherence 4%, the researchers found.

At North Carolina Blue, a similar effort to eliminate or reduce co-payments increased prescription compliance rates for plan participants with conditions such as diabetes, high blood pressure and congestive heart failure between 1.5% and 3.8%.

- Allison Bell