Objectives: Blue Cross and Blue Shield of Louisiana (BCBSLA) implemented the $0 Drug Co-pay (ZDC) program in 2014 for members with certain chronic conditions (diabetes, chronic heart disease, hypertension, chronic kidney disease, chronic obstructive pulmonary disease and asthma). Designed to reduce financial barriers by offering $0 copay for select drugs commonly prescribed to treat cardiovascular, diabetes, cholesterol, depression, and respiratory conditions, the program has achieved savings and improved medication adherence for these targeted members. In July 2020, BCBSLA expanded the ZDC program as a pharmacy benefit, removing the requirement of having one of the defined chronic conditions. The purpose of this study was to investigate the benefits of the ZDC program as a pharmacy benefit.

Methods: The study period was 2020 with participants having 12 months of continuous enrollment pre- and post-2020. BCBSLA propensity score matched ZDC participants to non-ZDC members on baseline demographics (age, gender, region), certain medical conditions (mental health conditions, cancer, pregnancy, etc.), baseline healthcare utilization and expenditures and whether members participated in the Quality Blue value-based care program. BCBSLA assessed differences across key outcomes of interest: health conditions (hypertension, diabetes), medication adherence, healthcare utilization and costs.

Results: ZDC participants with certain chronic conditions had improved medication adherence, clinical outcomes, fewer emergency department visits and cost savings.

Conclusions: Offering the $0 drug co-pay program as a pharmacy benefit continues to provide evidence that value-based insurance design can enhance member access to medication and improve health conditions.