At Pitney Bowes, value-based insurance design cut copayments and increased drug adherence.
To date, there has been little empirical evidence to support the broader use of value-based insurance design, which lowers copayments for services with high value relative to their costs. To address this lack of data, we evaluated the impact of the value-based insurance program of a US corporation, Pitney Bowes. The program eliminated copayments for cholesterol-lowering statins and reduced them for clopidogrel, a blood clot inhibitor. We found that the policy was associated with an immediate 2.8 percent increase in adherence to statins relative to controls, which was maintained for the subsequent year. For clopidogrel, the policy was associated with an immediate stabilizing of the adherence rate and a four-percentage-point difference between intervention and control subjects a year later. Our study thus provides an empirical basis for the use of this approach to improve the quality of health care.
Harvard Medical School, USA. nchoudhry@partners.org
Niteesh K
NK
Choudhry
Michael A
MA
Fischer
Jerry
J
Avorn
Sebastian
S
Schneeweiss
Daniel H
DH
Solomon
Christine
C
Berman
Saira
S
Jan
Jun
J
Liu
Joyce
J
Lii
M Alan
MA
Brookhart
John J
JJ
Mahoney
William H
WH
Shrank
D015331:Cohort Studies; D017046:Cost Savings; D005260:Female; D006264:Health Benefit Plans, Employee / Q000458:organization & administration*; D006801:Humans; D007356:Insurance, Pharmaceutical Services / Q000191:economics; D008297:Male; D008875:Middle Aged; D019982:Organizational Case Studies; D010349:Patient Compliance; D011785:Quality Assurance, Health Care / Q000191:economics*; D014481:United States