CVS Health Research Institute Provides More Evidence that Broader Prescription Drug Coverage Improves Health Outcomes

Coverage gaps or caps on coverage generally did not result in health care savings

Researchers urge policymakers to consider strategies other than limiting access to prescription drugs in efforts to reduce health care costs

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CVS Health

Jan 13, 2015, 08:30 ET

WOONSOCKET, R.I., Jan. 13, 2015 /PRNewswire/ -- A new analysis by researchers at Brigham and Women's Hospital and the CVS Health (NYSE: CVS) Research Institute, published on-line first in the American Journal of Public Health, shows that enhanced prescription drug insurance can improve patient health outcomes and reduce use of other, often costly, health care services.

"This review confirms the central role that effective prescription drug insurance can play as policymakers seek mechanisms to reduce rising health care costs in the United States," said Troyen A. Brennan, M.D., Chief Medical Officer, CVS Health and a study author. "Our analysis indicates that while expanding insurance benefits may lead to initial cost increases, these costs should be offset by future reductions in spending associated with preventable patient morbidity and mortality."

The authors conducted a systematic review of 23 studies that investigated prescription drug insurance changes between 1990 and 2013 and reported on associated health care use and patient health outcomes. Patients with government-sponsored drug insurance were the primary population studied. Across the reviewed research studies, the authors observed a consistent link between drug insurance and improved patient health status. For example, when drug insurance programs were enhanced or expanded, more patients were able to afford important medications enabling them to access and adhere to prescription medicines for chronic conditions. This, in turn, decreased costly complications and overall health care use, including hospitalizations from unmanaged or under-managed conditions. Several studies also showed a negative impact on patient health outcomes when insurers placed burdensome caps on drug benefits.

"As we continue to work towards balancing cost and quality in the U.S. health care system, this analysis suggests that policymakers should consider strategies other than limiting drug insurance," said the study's lead author, Aaron S. Kesselheim, M.D. Associate Professor of Medicine at Harvard Medical School and faculty member in the Division of Pharmacoepidemiology and Pharmacoeconomics, Brigham and Women's Hospital. "These could include strategies aimed at increasing the accessibility of essential prescription drugs, such as timely availability of generic alternatives and policies designed to improve medication adherence."

Many public and private insurers are taking steps to control rising health care costs. For example, some state Medicaid programs in recent years have enacted prescription drug restrictions by placing caps or limits on the number of prescriptions a patient can fill each month. The results of this systematic review of past studies suggests that restricting the availability of prescription drugs or prohibiting access could have collateral negative effects on patients' health and may not produce the expected cost-savings. They also suggest that economic calculations of Medicaid expansion have not taken into consideration the reduction in costs from the prevention of complications when millions of Americans previously without drug insurance are able to access important medicines to better manage chronic conditions.

The CVS Health Research Institute is focused on contributing to the body of scientific knowledge related to pharmacy and health care through research collaborations with external academic institutions, participation in federally-funded research, analysis and sharing of CVS Health data sources and coordination of pilot programs and initiatives. CVS Health Research Institute findings support a continuous quality improvement environment, which encourages product innovation and development to benefit CVS Health patients, clients and their members.

About CVS Health
CVS Health (NYSE: CVS) is a pharmacy innovation company helping people on their path to better health. Through our 7,800 retail pharmacies, more than 900 walk-in medical clinics, a leading pharmacy benefits manager with nearly 65 million plan members, and expanding specialty pharmacy services, we enable people, businesses and communities to manage health in more affordable, effective ways. This unique integrated model increases access to quality care, delivers better health outcomes and lowers overall health care costs. Find more information about how CVS Health is shaping the future of health at www.cvshealth.com.