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Consumers Using a Home Delivery Pharmacy More Likely to Choose Lower-Cost Therapies

 

09-Jan-2007: Consumers using home delivery for their prescriptions were more likely to choose a lower-cost preferred therapy after a formulary change, than those using a retail pharmacy, according to a study appearing in the December 2007 issue of the Annals of Pharmacotherapy.

The study by pharmacy benefit manager Express Scripts evaluated consumer behavior after the company recommended a formulary to better position consumers and plan sponsors to take advantage of the availability of generic Zocor® (simvastatin) in mid-2006.

More than 200,000 retail and home delivery consumers were included in the study which examined the relationship between plan design factors and patient formulary adherence. All consumers in the study were sent a notification letter by mail informing them of the formulary change. The mailing included therapeutic options and materials they could share with their physician as well as a website and toll-free number for more information. Home delivery consumers received additional messaging through refill mailings and an automated outbound call as the change approached. These consumers also received assistance in moving to the lower cost option after the formulary change.

The study found that more than half (52%) of home delivery consumers chose to switch therapies as compared to one third (33%) of retail consumers. Overall, 42% of consumers chose to switch to a formulary statin. Consumers using home delivery were also more likely to use the Web or call into Express Scripts for more information than retail users (50% versus 11%), which may be partially due to the fact that they use these channels to order their prescriptions.

A portion of the retail consumers were part of a rapid response program in which they received an education letter by mail about alternative therapy options soon after their first non-formulary statin refill. Receiving this letter increased their likelihood of changing to a lower cost statin by 28%.

“Creating a dialogue with consumers is a crucial factor in successfully changing behavior and delivering value at the consumer level,” explains Emily Cox, Ph.D., senior director of research at Express Scripts. “Home delivery consumers received additional information and were more likely to seek further assistance through the Web and by calling Express Scripts. Enhanced communication clearly has an impact. The effectiveness of the rapid response program for retail consumers also supports the value of enhanced communications.”

Other plan design factors positively influencing change included brand preferred and non-preferred copayment differentials. Interestingly, the study shows copay differentials have a greater impact on retail consumers.

Compared to home delivery consumers with savings opportunities of $15 or less, those in home delivery with a savings opportunity from $31 up to $40 had a 23% increase in the likelihood of switching to a preferred statin; for those with savings of $41 and higher the likelihood rose to 59%. Among retail consumers, compared to those who would save $10 or less, those with savings from $16 to $20 had a 41% increase in the likelihood of switching; those saving $21 or more had an 80% increase in the likelihood of switching.

In the case of statins, step therapy increased the likelihood of using formulary agents by 27% among both retail and home delivery consumers. Step therapy encourages first-use of equally effective lower cost agents. A prior statin change also had an impact on selecting a formulary option, increasing the chances by 84% for retail consumers and 23% for home delivery consumers.

“Encouraging use of formulary products requires a mix of activities with patient education and assistance clearly playing a significant role,” adds Cox. “Understanding the factors that influence consumer behavior is crucial to optimizing plan design and effecting change.”

About the Study

The study was a cross-sectional, cohort study of 211,083 consumers enrolled in one of 2,139 commercial (e.g. no Medicare or Medicaid) plan sponsors offering a three-tier benefit design and that changed atorvastatin from formulary to non-formulary status on January 1, 2006.

Source: PR-USA.net