Better Rx coverage associated with outcomes lift: study

Aaron Kesselheim, MD, associate professor of medicine at Harvard Medical School
Aaron Kesselheim, MD, associate professor of medicine at Harvard Medical School

An analysis published in the American Journal of Public Health, conducted by researchers at Brigham and Women's Hospital and the CVS Health Research Institute, found that expanding prescription drug insurance benefits could help reduce healthcare costs in the US and improve patient health outcomes. The research was funded by CVS through an unrestricted grant.


The authors of the analysis concluded, “Effective prescription drug insurance can…reduce the rising healthcare costs in the United States,” and that expanding benefits may trigger an initial surge in costs, but that these costs would then be offset by “reductions in spending associated with preventable patient morbidity and mortality.”


Authors—siftingthrough 23 studies of how prescription coverage changed from between 1990 and 2013—found that when drug insurance plans were enhanced or expanded, it  “decreased costly complications and overall healthcare use, including hospitalizations for unmanaged or under-managed conditions.”


Conversely, a number of studies stated there was a “negative impact on patient health outcomes when insurers placed burdensome caps on drug benefits.” The primary population of the analysis was comprised of patients with government-sponsored insurance, like Medicare and Medicaid.


The study's lead author, Aaron Kesselheim, MD, associate professor of medicine at Harvard Medical School, stated in a release, “This analysis suggests that policymakers should consider strategies other than limited drug insurance. 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 patient adherence.”