Eliminating Diabetes Drug Cost-Sharing Increases Adherence, Reduces Costs

Research presented at the AMCP 2017 Annual Meeting found that reducing member cost sharing to zero dollars for diabetes drugs improved diabetes drug adherence rates and reduced annual out-of-pocket costs.

“Providing zero dollar generic diabetes drug coverage has been associated with improved diabetes medication adherence,” Kevin Bowen, MD, senior health outcomes researcher at Prime Therapeutics, and colleagues wrote. “However, the impact of zero dollar diabetes drug coverage for both generics and branded formulary products has not been assessed.”

Dr Bowen and colleagues compared annual diabetes cost for members of the Schwan Food Company, a 24,006 member insurance plan, from the year before cost-sharing was eliminated (2014) to the year after (2015). During the study, 816 continuously enrolled members with diabetes were also matched to 10 control group members (n = 8160) from the Prime Therapeutics database in order to further analyze cost implications. 

The researchers noted that Schwan Food Company’s diabetes prevalence rating was 13.2% higher than the national prevalence rating, suggesting that Schwan’s diabetes-related pharmacy costs and utilization should be higher. 

The researchers found that out-of-pocket costs decreased by $253 per member per year among intervention group members compared with a $42 increase in the control group. However, total cost for diabetes drug costs were higher among the intervention group ($1010 vs $855). 

Dr Bowen and colleagues noted that these results “met the employer’s goal of reducing the diabetes medication cost burden on their employees and employee’s dependents.”

Furthermore, the researchers found that diabetes drug adherence increased by 4.4% among the intervention group compared with a 2.5% increase in the control group. 

They also found that the generic fill rate decreased by 4.6% in the intervention group. The researchers explained that these results were expected as a symptom of increased adherence, as most diabetes medications are only available as branded products. —David Costill