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Five Features Of Value-Based Insurance Design Plans Were Associated With Higher Rates Of Medication Adherence

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2014

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Health Affairs (Project Hope)
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Choudhry, N. K., M. A. Fischer, B. F. Smith, G. Brill, C. Girdish, O. S. Matlin, T. A. Brennan, J. Avorn, and W. H. Shrank. 2014. “Five Features Of Value-Based Insurance Design Plans Were Associated With Higher Rates Of Medication Adherence.” Health Affairs 33 (3) (March 1): 493–501. doi:10.1377/hlthaff.2013.0060.

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Abstract

Value-based insurance design (VBID) plans selectively lower cost sharing to increase medication adherence. Existing plans have been structured in a variety of ways, and these variations could influence the effectiveness of VBID plans. We evaluated seventy-six plans introduced by a large pharmacy benefit manager during 2007-10. We found that after we adjusted for the other features and baseline trends, VBID plans that were more generous, targeted high-risk patients, offered wellness programs, did not offer disease management programs, and made the benefit available only for medication ordered by mail had a significantly greater impact on adherence than plans without these features. The effects were as large as 4-5 percentage points. These findings can provide guidance for the structure of future VBID plans.

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