Enrollment in consumer-directed health plans (CDHPs) has evolved as a strategy to control healthcare costs and improve member satisfaction. According to the Mercer National Survey of Employer-Sponsored Health Plans, in 2010, 10% of employers offered their employees CDHPs; in 2011, that grew to 13%; and by June 8, 2012, 10% of employers offered CDHPs to their employees.
Including a preventive therapy option—which excludes drugs for chronic conditions from the member’s deductible and typically offers a lower cost-sharing to members—may contribute to better value by increasing member access to medications for chronic diseases, according to Shalini Thuppal Prakash, BPharm, MS, of CVS Caremark, Northbrook, IL. Mr Prakash compared adherence outcomes among CDHPs that offered a preventive therapy option, those that did not, and traditional health plans. Previous studies have shown that medication adherence can result in cost-savings to members, in addition to improving outcomes.
Using an integrated database of administrative pharmacy claims, Mr Prakash analyzed quarterly data (spanning the year 2010) from 47 clients with more than 1.2 million members in voluntary CDHPs and 1.8 million members in traditional health plans. Approximately 305,000 CDHP members had a preventive therapy option.
Adherence to medications for chronic diseases was significantly greater in CDHPs that offered a preventive therapy option than CDHPs without such an option— 65% versus 60%, respectively, for antidiabetes drugs; 69% versus 63%, respectively, for antihypertensive medications; and 67% versus 61%, respectively, for cholesterol-lowering drugs. However, the differences were not significant compared with traditional plans.
In addition, fewer members stopped taking their antihypertensive agents in CDHPs with a preventive therapy option compared with plans with no preventive therapy option (26% vs 30%, respectively) or cholesterol-lowering drugs (26% vs 29%, respectively); the one exception was for antidiabetes medications (33% vs 24%, respectively).
Finally, cost-sharing for prescription drugs was significantly greater in CDHPs than in the traditional plans— 34% versus 19%, respectively, for CDHP with a preventive therapy option (and 39% for CDHPs with no preventive therapy option). [Prakash TS. Consumer directed health plans (CDH plans): impact on member adherence to chronic condition medications.]