Walgreens (NYSE:WAG) (Nasdaq:WAG) today presented research on how value-based insurance design (VBID) programs can be optimized by targeting the sickest, least adherent and most costly patients. These findings, presented at the 2014 PBMI Drug Benefit Conference in Las Vegas, examined how the VBID model can be most successful by reaching these targeted employee sub-populations. VBID programs are emerging as a new benefit design focused on aligning patients' out-of-pocket costs, such as copayments and deductibles, with the value of health services. The model reduces barriers to high-value services such as preventive and chronic care therapies through lower costs to patients, while discouraging unproven, misused or low-benefit care through higher costs, ultimately improving health outcomes. Studies have shown that copayment reductions are often associated with improvements in medication adherence. “As employers continue to look for innovative ways to manage health care costs while keeping employees healthy, VBID programs have emerged as a viable and effective solution,” said Bobby Clark, PhD, MSPharm and Walgreens director of clinical outcomes and reporting. “However, we have only just begun to look at whether these VBID programs are reaching the employees who can benefit the most from the programs. Our recent research provides new insight into how to successfully reach these sickest and most costly patients. We hope to see future studies further investigate how opt-in VBID programs can become more targeted and what the full cost, adherence and outcomes benefits will be when these programs are fully optimized.” The Walgreens study, examined an employer-based VBID program implemented in January 2010, which eliminated the co-pay for generic anti-diabetic and anti-hyperlipidemic (cholesterol) medications. Eligible members (diabetic and/or high-cholesterol beneficiaries) were required to participate in a case management or wellness program to receive the zero co-pay benefit. The study findings include:
- About 4,100 beneficiaries enrolled, while almost 22,000 elected not to; among those that enrolled, 3,400 had diabetes and high cholesterol, compared to 2,400 of the non-enrolled.
- Both the enrolled diabetic and high cholesterol populations had higher adherence, the diabetic group’s adherence rate was 70 percent compared to about 45 percent for those not enrolled; the high cholesterol group’s adherence rate was about 66 percent vs. 55 percent for those not enrolled.
In a related study by Dr. Clark and colleagues published in the Journal of Managed Care Pharmacy, medication adherence and the costs for generic diabetes and cholesterol medications resulting from participation in a zero copay VBID program were examined. The zero copay program used a reduction in cost sharing to incentivize members to use more generic drugs and to enroll in a care management coaching program. The study also demonstrated that a value-based program can have a positive impact on adherence and cost outcomes among those who participate. 1About Walgreens As the nation's largest drugstore chain with fiscal 2013 sales of $72 billion, Walgreens ( www.walgreens.com) vision is to be the first choice in health and daily living for everyone in America, and beyond. Each day, Walgreens provides more than 6 million customers the most convenient, multichannel access to consumer goods and services and trusted, cost-effective pharmacy, health and wellness services and advice in communities across America. Walgreens scope of pharmacy services includes retail, specialty, infusion, medical facility and mail service, along with respiratory services. These services improve health outcomes and lower costs for payers including employers, managed care organizations, health systems, pharmacy benefit managers and the public sector. The company operates 8,200 drugstores in all 50 states, the District of Columbia, Puerto Rico and the U.S. Virgin Islands. Take Care Health Systems is a Walgreens subsidiary that is the largest and most comprehensive manager of worksite health and wellness centers and in-store convenient care clinics, with more than 750 locations throughout the country. 1 J Manag Care Pharm. 2014;20(2): 141-50