Prescription co-pay reduction program for diabetic employees.

Area of Science:

• Health Economics
• Pharmaceutical Policy
• Diabetes Management

Background:

• High prescription co-pays can be a barrier to medication adherence and increase healthcare costs.
• Understanding the impact of financial incentives on patient behavior is crucial for optimizing healthcare interventions.

Purpose of the Study:

• To evaluate the effect of reduced prescription co-pays for diabetes medications on pharmacy and medical utilization, medication adherence, and expenditures.
• To assess the impact of co-pay reduction on both generic and brand-name diabetes medication use.

Main Methods:

• Quasi-experimental design comparing a 12-month pre-intervention period to two years post-intervention.
• Analysis of pharmacy and medical utilization, medication adherence, and expenditures for a group of employees with diabetes.
• Statistical adjustment for age, sex, and comorbidity risk using generalized estimating equations.

Main Results:

• A modest increase in diabetes prescription utilization and medication adherence (approx. 3.0%) was observed in year 1, followed by a decline in year 2.
• Brand-name diabetes medication use increased by approximately 5%, while generic use decreased.
• Emergency room visits and hospitalizations decreased in both years, leading to reduced healthcare expenditures in year 2.

Conclusions:

• Reducing prescription co-pays for diabetes medications can lead to a modest increase in adherence and utilization.
• While some cost savings for employers may occur, additional strategies are needed to sustain medication adherence and optimize outcomes.
• Targeted interventions may be necessary to encourage the use of cost-effective generic medications.