HealthLeaders-InterStudy, a leading provider of managed care market intelligence, reports that UnitedHealth Group's (formerly Sierra Health Services) Health Plan of Nevada Senior Dimensions HMO has significantly reduced copays for the drugs that treat the most common chronic conditions. According to the latest Nevada Health Plan Analysis, while the move is expected to add an additional $4.50 per month per member to the health plan's costs, in the long-term it may mean more seniors are taking their medications and have improved health outcomes.
According to plan officials, the senior population is an ideal group for such a pilot program because of its smaller numbers and higher incidence of chronic conditions. Plan officials examined the plan's generic fill rates that demonstrated how important cost is to seniors on the Medicare plan. The most widely prescribed brand-name drugs for diabetes, chronic obstructive pulmonary disease, asthma, high blood pressure and seizures were chosen for the cost reduction. Copays for brand-name drugs have fallen from $20 to $30 a month to $3 to $5.
Studies have shown that failure to take medications as prescribed creates a financial burden on the healthcare industry and that people are more compliant with their medications when those drugs are more affordable.
"This is an interesting move on the part of Health Plan of Nevada as its drug spend will increase by about $2.9 million annually," said Heather Johnston, analyst with HealthLeaders-InterStudy. "However, this program will likely enable the plan to gain market share as seniors with chronic conditions will be drawn to the low copay option. If the lower copay option produces the desired results, more plans, including those for commercial members, may consider this approach."
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