Stakeholder perspectives on facilitators and barriers to implementing a zero-dollar copay program for chronic...

Area of Science:

• Health Services Research
• Public Health
• Health Economics

Background:

• Type 2 diabetes mellitus (T2D) presents a significant public health challenge.
• Suboptimal medication adherence in T2D is often linked to high drug costs.
• The $0 Drug Copay (ZDC) program was implemented to mitigate medication expenses.

Purpose of the Study:

• To explore barriers and facilitators for the updated Blue Cross and Blue Shield of Louisiana's ZDC program.
• To assess the perceived effectiveness and identify areas for improvement in the ZDC program.

Main Methods:

• Qualitative descriptive analysis of focus group discussions and semi-structured interviews.
• Participants included health plan leadership, health coaches, and healthcare providers (n=15).
• Data collected between October 2022 and July 2023, analyzed using NVivo software.

Main Results:

• Participants reported positive feedback and perceived significant benefits of the ZDC program.
• Key themes identified: reduced patient/provider friction, alignment with healthcare values, need for expanded coverage and education.
• Program administration was not negatively impacted by COVID-19 due to benefit-level programming.

Conclusions:

• The ZDC program effectively aligns goals and benefits patients, providers, and health systems.
• Expansion of drug classes, conditions, and enhanced patient/provider education can maximize program potential.
• Reduced-copay programs show promise for improving medication adherence, glycemic control (HbA1C), and overall health outcomes.