Value-Based Benefits: The Impact Of Pharmacy Plan Design

Value-Based Benefits: The Impact of Pharmacy Plan Design Source: A Broader Reach for Pharmacy Plan Design , Integrated Benefits Institute, 2007 IBI Research - 2007

Key Insights:
Medication adherence for those with chronic RA is poor, despite beneficial effects from disease-modifying anti-rheumatic drugs (DMARDs)
Increasing co-pays by $20 per script further reduces the proportion of those filling at least one script for DMARDS by 35%
Research by others shows additional medical expense offsetting savings from increased co-pays. This research finds additional disability costs.
Those in the study filling at least one DMARD script (vs. those filling none) have 36% lower STD incidence and 6% shorter duration
If those not filling DMARD scripts actually filled them at the same rate as those filling one or more, the employers in the study would reduce lost-productivity costs by 26%
The full study is available to members of IBI. Commentary is available in Notes view.
Purpose: To demonstrates how increasing co-pays for rheumatoid arthritis (RA) reduces medication adherence and increases disability and lost productivity IBI Research on Value-Based Benefit Design

Results Attract Broad Media Attention

Two Classes of Rheumatoid Arthritis Drugs Examined
Modifying disease progression
Disease-modifying anti-rheumatic drugs (DMARDs)
Anti-tissue necrosis factor (anti-TNF) agents
Biologic response modifiers
Select anti-malarials used as DMARDs
Treating and relieving pain/inflammation symptoms
Non-steroidal anti-inflammatory drug (NSAIDs)
Cyclo oxygenase 2 (Cox-2) inhibitors
Analgesics
Source: A Broader Reach for Pharmacy Plan Design , Integrated Benefits Institute, 2007

Average Medication Adherence Source: A Broader Reach for Pharmacy Plan Design , Integrated Benefits Institute, 2007

Impact of Out-of-Pocket Cost Source: A Broader Reach for Pharmacy Plan Design , Integrated Benefits Institute, 2007

Filling One or More DMARD Script Reduces STD Incidence -36% Source: A Broader Reach for Pharmacy Plan Design , Integrated Benefits Institute, 2007

Filling One or More DMARD Script Reduces STD Duration -6% Source: A Broader Reach for Pharmacy Plan Design , Integrated Benefits Institute, 2007

Savings in Lost-Productivity Costs -- For no-Script Group -- -26% Source: A Broader Reach for Pharmacy Plan Design , Integrated Benefits Institute, 2007

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Value-Based Benefits: The Impact Of Pharmacy Plan Design

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