OBJECTIVES

: Rising out-of-pocket medication costs are a deterrent to treatment access. Lower medication adherence adversely affects downstream health outcomes and total medical costs. Herein, we investigated the extent to which an add-on to high deductible health plans (HDHPs) – a product that waives the deductible for certain tiers of preventative medications in seven drug classes (respiratory, cholesterol, diabetes, hypertension, osteoporosis, mental health, and prenatal vitamins) – influences prescription pickup rates and medication adherence as well as healthcare costs and utilization.

METHODS

: The study population included data from a large, commercial insurer for 241,108 members enrolled in HDHPs between 2014 and June 2018. Of these members, 3.3% adopted the add-on to their HDHP at some point in the study period. Difference-in-difference models were used to evaluate the impact of the HDHP add-on across all endpoints, and accounted for the longitudinal study design.

RESULTS

: In certain models, we observed that the adoption of the HDHP add-on statistically significantly decreased per member per month medical costs by more than 10%. These models also showed a statistically significant reduction in emergency room and total inpatient visits among members who acquired the HDHP add-on. After stratifying mixed models by preventative medication class, we found that waiving the deductible of preventative respiratory medications significantly increased the medication pickup rate. The HDHP add-on adoption was also associated with an increased adherence to hypertension and osteoporosis medications.

CONCLUSIONS

: Overall, our results provide suggestive evidence that including an add-on product to HDHPs that waives the deductible for certain tiers of preventative medications may increase adherence to and pickup rates of certain medication classes and decrease both healthcare utilization and cost.