Even With Increasing Rx Drug Copays, Seniors Still Access Medicines, Health Affairs Study Finds
While "aggressive" cost-sharing requirements for prescription drugs lower overall health plan expenses and cost seniors more, they do not decrease rates of pharmaceutical use, a study published today on the Health Affairs Web site found. Study authors Cindy Parks Thomas, a research scientist at Brandeis University's Schneider Institute for Health Policy; Stanley Wallack, the institute's founder and executive director; and colleagues examined drug claims in 2001 of people ages 65 and older covered by self-insured employer health plans with drug coverage administered by a pharmacy benefits manager. All plans that researchers studied were fee-for-service, offered "generous" benefits such as coverage of generic and brand-name prescriptions and provided incentives for patients to use lower-priced medications, such as mail-order, prior authorization and tiered copayment structures. According to the study, seniors who are in plans that employ cost-sharing requirements generally purchase more generic drugs and more medicines through mail order. In plans that have higher copays or use a tiered copay system but had limited mail-order use, the researchers found a "modest" 6% decrease in seniors' drug use. However, drug use did not decrease in plans that had higher copays or tiered systems and higher rates of prescriptions filled through mail order systems (Thomas et al., "Impact of Health Plan Design and Management on Retirees' Prescription Drug Use and Spending," Health Affairs, 12/4).
Wallack said that plans that do employ higher drug copays tend to offer more incentives for seniors to use generic medicines and mail-order pharmacies. "A lot of people were saying if you raise the price to the individual, they're going to stop using drugs. We found you could offset the raising of prices by people being more prudent about what kinds of drugs they're going to use or where they get their drugs," he added (Chesto, Boston Herald, 12/4). The study is available online.This is part of the California Healthline Daily Edition, a summary of health policy coverage from major news organizations. Sign up for an email subscription.