The Florida Health Care Coalition says a value-based prescription co-payment system seemed to help employers generate a return of up to $1.33 over a 3-year period on every extra dollar spent up front on prescription drugs.
The Florida Health Care Coalition (FHCC) says a value-based prescription co-payment system seemed to help employers generate a return of up to $1.33 over a 3-year period on every extra dollar spent up front on prescription drugs.
The FHCC, Orlando, Fla., began a "value-based insurance design" (VBID) study in January 2006.
Researchers at the FHCC and other organizations have published an evaluation of the study in the January issue of Health Affairs.
Designers of a VBID program try to get health plan members to take the steps most likely to cut total health care costs by reducing or eliminating some out-of-pocket costs, such as some prescription drug or office visit co-payments.
The managers of the Florida VBID program study have focused on health plan members with diabetes.
The study managers divided 1,876 health plan participants into two groups.
One group consisted of employees and dependents had value-based insurance. Managers lowered the co-payment rate for all generic and brand-name diabetes medications to 10%. Some of the patients in that group participated in a diabetes management program and some did not.
The second group consisted of similar employees and dependents who had ordinary insurance. For diabetes medications, copayment rates ranged from 10% for generic drugs to 35% for brand-name drugs not on the plan's preferred drugs list. Some of the patients in the group participated in a diabetes management program and some did not.
After the first year the VBID program was in effect, use of diabetes medication was 3.8 percentage points higher among diabetes management program members who had VBID insurance than for diabetes management program members with conventional coverage, the researchers say.
The gap in medication usage increased to 6.5 percentage points after 3 years, the researchers say.
The researchers found that compliance rates were much better for patients who had VBID coverage combined with a diabetes management program than for patients who had VBID coverage without using a diabetes management program.
- Warren S. Hersch
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