Implementing Total Replacement CDHP Resulted In Decreased Prescription Use: EBRI

Moving to an HSA-eligible high deductible health plan reduced the number of both generic and brand-name prescriptions filled, according to data from one large employer that implemented a total replacement consumer-driven health plan (CDHP). The study, Brand-Name and Generic Prescription Drug Use After Adoption of a Full-Replacement, Consumer-Directed Health Plan With a Health Savings Account, found that at the end of the four-year follow-up period, the generic drug rate was greater by 4.5 percentage points for hypertension, 15.4 percentage points for dyslipidemia, and 7.8 percentage points for asthma/COPD (chronic obstructive pulmonary disease). No significant effects were detected for diabetes. The report was published by the Employee Benefit Research Institute (EBRI) in the March 2014 EBRI Notes.

EBRI noted that generic drug rates, or GDR, can rise if the number of generic fills increases or if the number of brand-name fills decreases, or a combination of the two. In response to the HSA plan, it was found that higher GDRs were largely achieved due to individuals discontinuing use of brand-name drugs without substituting generic alternatives.

Paul Fronstin, director of EBRI’s Health Education and Research Program, said CDHP plan sponsors may want to have maintenance medications deemed as preventive, and (like certain cancer screenings) exempt them from the deductible. “Although lower prescription-drug use can save pharmacy costs for plan sponsors, it could also result in even higher downstream medical costs if people stop taking maintenance drugs for chronic diseases,” Fronstin said.

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