Copays, compliance, and costs

It will come as no surprise to most that a significant number of people do not take their medications as recommended. In fact, the number appears to be about 20%, at least according to a study funded by pharmaceutical company GlaxoSmithKline covering 429,000 Ohio health insurance claims for conditions such as diabetes, congestive heart failure and asthma. GSK’s study indicates that non-compliance adds over $700 million to the state’s health care costs.
Again not surprisingly, GSK has a plan to fix this problem. It involves eliminating copays for individuals if they agree to talk with a pharmacist at least once a month, and have the pharmacist check their blood sugar, pressure, and feet for sores. The extra payment to the pharmacist for their time, as well as the employees’ copays, will be funded by insurance companies or employers.
And last in this “dog bites man” story is the rather obvious note that although GSK et al will benefit by selling more drugs, they don’t appear to be contemplating any financial contribution to this noble cause.
What does this mean for you?
Two things.
One, another study that demonstrates the positive financial impact of reducing or removing copays for medications for chronic conditions. This has been documented previously, and calls into question what sems to be the main premise of the consumer-directed health plan – the theory that individuals will spend their money in such a way as to maximize their health.
Two, yet another example of big pharma shooting themselves in the foot. To look both smart and magnanimous, all GSK had to do was offer to partially fund the pharmacists’ extra time, provide the blood pressure monitors, reduce prices for insulin by $3 for those employers participating in the plan (either directly or through rebates) or otherwise do something altruistic. Instead, they fund a study (yay) that shows it makes sense for the rest of us to buy and use more drugs, thereby generating more revenue and profit for GSK et al.