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Health Aff (Millwood). 2014 Mar;33(3):493-501. doi: 10.1377/hlthaff.2013.0060. Epub 2014 Feb 12.

Five features of value-based insurance design plans were associated with higher rates of medication adherence.


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.


Evidence-Based Medicine; Health Spending; Organization and Delivery of Care; Pharmaceuticals; Quality Of Care

[Indexed for MEDLINE]

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