title: Five features of value-based insurance design plans were associated with higher rates of medication adherence.
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.
authors: Niteesh K
authors: NK
authors: Choudhry
authors: Michael A
authors: MA
authors: Fischer
authors: Benjamin F
authors: BF
authors: Smith
authors: Gregory
authors: G
authors: Brill
authors: Charmaine
authors: C
authors: Girdish
authors: Olga S
authors: OS
authors: Matlin
authors: Troyen A
authors: TA
authors: Brennan
authors: Jerry
authors: J
authors: Avorn
authors: William H
authors: WH
authors: Shrank
mesh_terms: D019090:Case Management / Q000191:economics / Q000706:statistics & numerical data; D002908:Chronic Disease / Q000191:economics* / Q000628:therapy*; D015331:Cohort Studies; D017047:Cost Sharing / Q000191:economics / Q000706:statistics & numerical data; D003362:Cost-Benefit Analysis / Q000191:economics / Q000706:statistics & numerical data; D003924:Diabetes Mellitus, Type 2 / Q000188:drug therapy / Q000191:economics; D016527:Drug Costs / Q000706:statistics & numerical data; D019317:Evidence-Based Medicine; D005260:Female; D054625:Healthcare Disparities / Q000191:economics / Q000706:statistics & numerical data; D006801:Humans; D006973:Hypertension / Q000188:drug therapy / Q000191:economics; D019458:Insurance Coverage / Q000191:economics* / Q000706:statistics & numerical data*; D007356:Insurance, Pharmaceutical Services / Q000191:economics* / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D014481:United States; D062505:Value-Based Purchasing / Q000191:economics* / Q000706:statistics & numerical data*; D016903:Drug Monitoring
keywords: Evidence-Based Medicine; Health Spending; Organization and Delivery of Care; Pharmaceuticals; Quality Of Care