A CHIBE study published today in Health Affairs found that a refill synchronization program – in which patients received all prescription refills at the same time – increased medication adherence by an average of three to five percent compared to a control group. Researchers found that refill synchronization had the greatest impact on patients who were least likely to take their medication before the intervention, increasing medication adherence in this subgroup by nine to thirteen percent over the control group. “The logistical challenges involved with keeping track of remaining pills and obtaining timely refills and renewals are magnified for patients who need to take multiple medications, and often create an obstacle to medication adherence,” said lead author Jalpa A. Doshi, PhD. The results of the study suggest that syncing prescription refills may be an effective strategy for reducing these obstacles.
Two new studies led by Jalpa Doshi have found evidence that cost-sharing arrangements are associated with significant reductions in access to specialty drugs. Both papers are published online in the American Journal of Managed Care.
In the first study, the team conducted a review of the literature and found evidence that high out-of-pocket costs were generally associated with lower use of specialty drugs. In the second study, the team examined Medicare claims data and found that “Part D” (prescription drug plan) co-insurance policies for specialty drugs seem to be reducing or delaying use of a lifesaving class of leukemia therapies.
Jalpa Doshi, Pengxiang (Alex) Li, and colleagues have been announced as the first-place winners in the “PAN Challenge: Balancing Moral Hazard, Affordability and Access to Critical Therapies in the Age of Cost Sharing” launched by the Patient Access Network (PAN) Foundation in collaboration with the American Journal of Managed Care (AJMC). The competition called for papers addressing how federal cost sharing policies affect the ability of individuals with chronic and rare diseases to have affordable access to critical therapies and what policy solutions are likely to improve access.
Their paper titled “High Cost Sharing and Specialty Drug Initiation under Medicare Part D: A Case Study in Newly Diagnosed Chronic Myeloid Leukemia Patients “ won the first prize of $10,000. More importantly, the paper will be published in a special AJMC supplement and presented at a Cost Sharing Roundtable convened at the Kaiser Family Foundation Barbara Jordan Conference Center in Washington D.C. next month.
Sources: Washington Post, January 12, 2009; USA Today, January 12, 2009; Forbes, January 12, 2009. The study was cited by Senator Patty Murray at the VA Secretary Senate Confirmation hearing on January 14, 2009, CSPAN.
Jalpa Doshi, PhD and a team which included three other CHIBE researchers published results in the journal Circulation on a quasi-experimental study comparing lipid-lowering medication adherence in patients before and after the 2002 copayment increase at the Philadelphia VA Medical Center.