Promoting Compliance With Pharmacy Benefit Incentives
In an April 14, 2006 news release, CIGNA Pharmacy Management (CPM) announced its launch of prescription drug plan options designed to promote medication compliance.
One option simply offers employers coverage that waives the deductible “for over 700 standardly [sic] covered preventive prescription drugs,” presumably at a higher cost than plans mandating a deductible. The tie-in to compliance appears limited to the patients’ reduced cost of these medications. This option would also offer employers coverage, for an additional fee, of “medications for tobacco cessation, weight loss and nutritional deficiency.”
The other option appears more interesting vis-à-vis compliance. This plan allows sponsors of CIGNA Choice Fund consumer-driven plans “to provide this higher level of coverage as an incentive to encourage employees with diabetes, cardiac conditions or chronic obstructive pulmonary disease to actively participate in a disease management program offered as part of the employer’s health plan.” My reading of this is that employers who purchase this option would waive deductible for patients with the listed chronic disorders if those patients participate in the disease management programs CIGNA also sells the employers.
While I’m less taken with the first option that allows employers to waive the deductible for a prescribed list of medications, it does demonstrate some flexibility and a focus on encouraging patients to follow their medication regimen (by reducing their costs), two qualities that have been all too rare in health coverage plans.
The idea of waiving the deductible in exchange for a patient’s cooperation with a disease management program in his or her own best interest is the kind of compliance enhancement that I’ve long promoted. Assuming the mechanics of the program are effective and the pricing is structured such that the purchasing employer benefits as well as the patient and CIGNA, I think this an impressive first step toward aligning the interests of all the stakeholders. It could, however, be further improved by adding incentives tied to patient compliance for the clinicians, a group conspicuously absent from the programs described in the press release.
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