12/05/2011
Austin FraktI want to quickly note that on this blog we’ve covered the effect of drug copayments on patients’ adherence to drug regimens:
- Many people in the US do not fill prescriptions due to cost, even when they’re insured (follow the links within this post).
- Even small increases in copayments can lead to reductions in medication use.
- Increased drug cost-sharing has led to increases in ED use and hospitalization, particularly for the elderly.
It’s the last point that leads naturally to the consideration of value-based insurance design. It’s completely reasonable to consider such an approach for childhood asthma (for which cost-sharing is a documented issue), as well as other medications and therapies.
by Brad F on December 5th, 2011 at 19:21
An even more potent argument: give rx to folks with a more ominous prognosis, at no charge, and uptake still suboptimal:
http://www.nejm.org/doi/full/10.1056/NEJMsa1107913
Non-adherence is multifactorial, and adding costs of meds with benefits>>>risks deepens the burden. Skin in the game is a limited tool, not the answer. Although, for right population, right drug, right disease, it has its place.