Pocket Change: Barrier to Better Care
Last month this WebMD blog examined important reasons why some folks have problems taking all of their medications - the precise terminology is patient compliance. There are lots of reasons that contribute to poor compliance but the simplest one to appreciate is the fact that the patient never filled the prescription in the first place!
Now, at first glance, that doesn't seem to make any sense at all: go to all the trouble to make an appointment, sit through the complete eye exam, listen to the doctor's counseling, and then simply go home without any treatment whatsoever. What's up with that?
What could possible deter an intelligent adult from getting an eyedrop prescription filled? What if the prescription cost $132? True, many might forego the prescription. What about $2 or even $1? Believe it or not, it happens every day.
A new study in the journal Medical Care claims that modest copayments significantly reduce drug usage. Pharmacologic researchers from the Oregon Health & Science University analyzed blinded data from a huge number of Oregon Medicaid records and discovered that enforcing a new $2 prescription copay rule led to an immediate 17% drop in prescription drug usage. Previously, Medicaid beneficiaries were not required to make copayments for prescription drugs. After the rule went into effect some folks simply refused to pay the $2 copay and went home empty-handed.
This study is not about poverty or under-served communities - its findings apply to everyone. The researchers used a Medicaid database because all of the required information was readily available from one electronic source. Trying to complete the same study involving the private insurance sector would be nearly impossible to accomplish.
Interestingly, copay refusal was not uniform. Diabetics and folks with cardiovascular diseases paid the money and continued their medications, whereas compliance rates for people with respiratory problems and depression decreased the most. Eyedrop prescriptions were somewhere in-between.
Maybe you're mumbling to yourself, "Those cheapskates deserve to get sicker; they only have themselves to blame!" Whoa, not so fast! Anytime an unfilled prescription sits unused on the shelf it's bad for everybody. Let's say those who refuse to pay the $2 for each of their medications actually do get sicker and land in the hospital. Who will end up paying the bill? Taxpayers and those paying health insurance premiums will inevitably shoulder that debt. This problem cuts through all economic strata.
According to the research organizers, the few previous studies of this issue have also found comparable reductions in medication use in response to cost-sharing measures. This suggests that a more thoughtful approach to crafting cost-sharing policies should be considered. The authors suggest, for example, health plans should eliminate copays for drugs with strong evidence of effectiveness. In other words, don't give folks an excuse not to take their medicine.
Until a national health care program is developed, doctors, patients and families need to make sure that everybody who is prescribed medication has access to their medicines and uses them as prescribed. Over the short term or over the long term, skipping medical therapy generates no savings whatsoever. It is a false economy.
REFERENCE: Medical Care, June 2008, Vol 46; pages 565-572.
Related Topics: Technorati Tags: patient compliance, copay, drugs, medicine, health and wellness
Now, at first glance, that doesn't seem to make any sense at all: go to all the trouble to make an appointment, sit through the complete eye exam, listen to the doctor's counseling, and then simply go home without any treatment whatsoever. What's up with that?
What could possible deter an intelligent adult from getting an eyedrop prescription filled? What if the prescription cost $132? True, many might forego the prescription. What about $2 or even $1? Believe it or not, it happens every day.
A new study in the journal Medical Care claims that modest copayments significantly reduce drug usage. Pharmacologic researchers from the Oregon Health & Science University analyzed blinded data from a huge number of Oregon Medicaid records and discovered that enforcing a new $2 prescription copay rule led to an immediate 17% drop in prescription drug usage. Previously, Medicaid beneficiaries were not required to make copayments for prescription drugs. After the rule went into effect some folks simply refused to pay the $2 copay and went home empty-handed.
This study is not about poverty or under-served communities - its findings apply to everyone. The researchers used a Medicaid database because all of the required information was readily available from one electronic source. Trying to complete the same study involving the private insurance sector would be nearly impossible to accomplish.
Interestingly, copay refusal was not uniform. Diabetics and folks with cardiovascular diseases paid the money and continued their medications, whereas compliance rates for people with respiratory problems and depression decreased the most. Eyedrop prescriptions were somewhere in-between.
Maybe you're mumbling to yourself, "Those cheapskates deserve to get sicker; they only have themselves to blame!" Whoa, not so fast! Anytime an unfilled prescription sits unused on the shelf it's bad for everybody. Let's say those who refuse to pay the $2 for each of their medications actually do get sicker and land in the hospital. Who will end up paying the bill? Taxpayers and those paying health insurance premiums will inevitably shoulder that debt. This problem cuts through all economic strata.
According to the research organizers, the few previous studies of this issue have also found comparable reductions in medication use in response to cost-sharing measures. This suggests that a more thoughtful approach to crafting cost-sharing policies should be considered. The authors suggest, for example, health plans should eliminate copays for drugs with strong evidence of effectiveness. In other words, don't give folks an excuse not to take their medicine.
Until a national health care program is developed, doctors, patients and families need to make sure that everybody who is prescribed medication has access to their medicines and uses them as prescribed. Over the short term or over the long term, skipping medical therapy generates no savings whatsoever. It is a false economy.
REFERENCE: Medical Care, June 2008, Vol 46; pages 565-572.
Related Topics: Technorati Tags: patient compliance, copay, drugs, medicine, health and wellness