Approximately 135,000 Blue Cross and Blue Shield of North Carolina, or BCBSNC, members can directly benefit from the Medication Dedication program, which began on Jan. 1.
By waiving copays on all generic medications for congestive heart failure, high blood pressure, high cholesterol and diabetes, and moving more than 40 brand-name drugs for these conditions to a lower-cost drug classification category, BCBSNC hopes that affordability will induce members' medication adherence.
These four conditions are prevalent in BCBSNC's population, according to Ron Smith, MD, vice president of employer health and pharmacy.
In addition, because patients often don't have symptoms associated with high-blood pressure and cholesterol, medication compliance and persistence are low. "This hurts the opportunity to positively impact the healthcare of our members," Smith said.
In a 2004 AARP survey of Americans aged 50 and older, the 25 percent who reported not filling a prescription written by their doctor in the past two years cited cost as the main barrier. Several studies note that medication adherence failure costs approximately $100 billion annually.
Improving medication compliance and persistence will result in lowered healthcare costs, Smith said.
BCBSNC will implement a rigorous tracking and evaluation process that will enable access to a longitudinal view of both individual and population health.
The health plan's goal is to achieve a 7 percent improvement for 2009 in the medication possession ratio. Other goals tied to healthcare outcomes will also be developed.
"The BCBS North Carolina initiative is certainly a promising program that should encourage patient compliance," said Markella Kordoyanni, healthcare consultant for Datamonitor.
The expanded use of generics, as promoted in BCBSNC's Medication Dedication program, is one of the factors contributing to the overall growth of the generics market. Datamonitor research indicates that the global generics market is expected to show strong double-digit growth over the next five years.
Other Datamonitor research also shows that cardiovascular, infectious diseases, gastrointestinal and autoimmune and inflammatory disorder therapeutic areas will have an "above average" number of generic entrants.
"Datamonitor's primary pharmacist research supports findings that CNS, oncology, women's health, diabetes and endocrinology, attract fewer generic entrants despite their large market sizes," said Kordoyanni. "Therefore, it will be interesting to see how this plan will impact prescription of generic drugs for chronic disease."