Prescription Drugs

Employers, Insurers Begin To Reduce or Eliminate Prescription Drug Copays for Some Chronic Disease Medications

The Wall Street Journal on Tuesday examined how an increased number of employers and health insurers have begun to reduce or eliminate copayments for certain medications for chronic diseases as part of an effort to "curb soaring health care costs" by "preventing costly health crises down the road." According to the Journal, "mounting evidence" indicates that higher copays for certain treatments might not "make long-term economic sense" because they have "discouraged some people from taking essential medications."

A 2004 RAND study of more than 80 companies and commercial health plans found that individuals who took medications for chronic diseases on a regular basis reduced their treatments by between 8% and 23% when their copays doubled. In addition, early "experiments with providing free drugs for chronic disease have produced results -- reducing costs and helping people stay out of the hospital and emergency rooms," the Journal reports.

Employers such as Marriott International, Procter & Gamble, Eastman Chemical and Pitney Bowes have begun to reduce or eliminate copays for certain medications. Andrew Scibelli -- manager of the health management programs at Florida Power & Light, which has considered the reduction or elimination of copays for medications for diabetes and coronary artery disease -- said, "Cost shifting (onto employees) is the easier way to attack cost. But it comes right back at you because you're not attacking the root cause."

Aetna Study
Health insurer Aetna later this year plans to launch "one of the most ambitious studies of the tailored approach" to copays for medications, the Journal reports. For the study, Aetna will eliminate copays for the four classes of prescription medications recommended for individuals who have experienced heart attacks: statins, ace inhibitors, beta blockers and ARBs.

In addition, Aetna will examine the effect of the move on outcomes and cost over a three-year period. Troyen Brennan, chief medical officer for Aetna, said that "we think we'll reduce costs very rapidly" with the study. "If the three-year study bears out such cost savings," Aetna plans to "implement the approach across its health plans and expand it to more than a dozen other types of medications," the Journal reports (Fuhrmans, Wall Street Journal, 5/8).