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In one study, compliance, or taking a medication as prescribed by yourdoctor, was nearly eight percentage points higher for home delivery pharmacypatients taking medications to treat high blood pressure. These patients were78.6 percent compliant, but those using a retail pharmacy were 70.8 percentcompliant.
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"It has been estimated that roughly half of patients do not take theirmedications as prescribed by their doctors. Understanding how to improvecompliance is an important concern for all health care providers," explainedEmily Cox, Ph.D., a study author and leader of Express Scripts researchdepartment.
Cox explained that in addition to cost savings, home delivery promotesbetter medication compliance through patient communications such as refillreminders by phone or email, renewal assistance, a convenient reorder process,and less frequent re-ordering.
In the second study, a letter alerting patients to the availability of ageneric alternative, the likelihood of choosing generics in home delivery was34% greater compared to the impact in retail. The letters were sent followingthe introduction of generic Ambien(R) (zolpidem) in 2007.
Express Scripts estimates that use of generic sleeping aids will increaseto 70 percent of all sleeping aid prescriptions in 2008. However, even thatincrease will not capture the $1.5 billion in additional savings availablenationwide for commercial and government-paid plans from realizing thecategory's full generic potential of 95 percent.
"Billions in savings are at stake when you account for a similar impact inother therapy classes," pointed out Cox. She added that home deliverycustomers responded at a higher level to a letter from Express Scripts becauseit clearly identified potential savings from using a generic that wouldprovide the same therapeutic benefit. "The assistance and patient advocacyavailable in the home delivery channel led consumers using that channel torespond at a higher level," according to Cox.
"Financial incentives are important but not enough to realize the fullmoney-saving potential of therapeutically equivalent generics. Timelycommunications -- in this case immediately after a drug goes generic -- needto be coupled with the right financial incentives to increase the number ofconsumers choosing a generic," said Cox.
Earlier this year, Express Scripts announced the establishment of theCenter for Cost-Effective Consumerism to accelerate development of an advancedunderstanding of the consumer and of what works -- and what doesn't work --when trying to change the way consumers use health care.
The Center was inspired by research showing that a targeted communicationsprogram implemented around the 2006 introduction of generic Zocor(simvastatin) was nearly two to three times more effective than financialincentives alone. The greatest impact came among consumers using thecompany's home delivery pharmacy. The campaign generated over a billiondollars in savings for Express Scripts' pharmacy benefit plan sponsors andconsumers.
"Despite the predictions of classical economic theory, it's clear thatgiving consumers price information alone is not enough. Instead,communications and a more advanced understanding of the consumer are needed toaccelerate better health and value," said Robert Nease, PhD, the company'schief scientist.
For more information on the Center for Cost-Effective Consumerism, visithttp://www.consumerology.org.
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