When faced with large increases in copayments, many patients stop taking their meds rather than switch to cheaper drugs, according to a study in today's New England Journal of Medicine.
Researchers at Harvard Medical School and Medco Health Solutions, a pharmacy benefits management company in Franklin Lake, N.J., surveyed a large company with 55,500 hourly workers that switched to a three-tier copayment system. The switch raised the employees' copay for brand-name drugs from $7 to $30.
Among enrollees who were taking brand name statins, 49% switched to less expensive drugs but 21% stopped taking the drug, the study reports. Researchers also found that 16% with prescriptions for ACE inhibitors stopped taking them and 32% taking acid reflux drugs dropped them.
But researchers added that there was not such a marked drop in utilization at another company that raised copayments for brand names less dramatically - from $12 to $24 - when adopting its three-tier approach.
"The associated changes in copayments can substantially alter out-of-pocket spending by enrollees, the continuation of the use of medications, and possibly the quality of care," the study concludes.
The Kaiser Family Foundation reports that three-tier plans for drugs are now common, with 63% of employees who have prescription drug benefits using them, up from 27% in 2000.
For an abstract of the New England Journal of Medicine article click here.