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The Influence of Targeted Education on Medication Persistence and Generic Substitution among Consumer-Directed Health Care Enrollees

Authors


  • Address correspondence to Rebecca Sedjo, Ph.D., Office of Evidence-Based Pharmacy Benefit Design, One Express Way-HQ2N02, St. Louis, MO 63121; e-mail: rsedjo@express-scripts.com. Emily R. Cox, Ph.D., is with the Office of Evidence-Based Pharmacy Benefit Design, Express Scripts Inc., St. Louis, MO.

Abstract

Objective. To evaluate an educational outreach among consumer-directed health plan (CDHP) enrollees on medication persistence and lower-cost generic substitution within four chronic medication therapies.

Study Setting. A cross-sectional analysis using pharmacy claims data from a national employer group that began offering a CDHP in 2006 and implemented an educational outreach to some CDHP enrollees in 2007 was used.

Methods. The intervention group was comprised of CDHP enrollees who received education outreach and was compared with CDHP enrollees without the educational outreach. Adjusted and unadjusted medication persistence and lower-cost generic substitutions were compared between groups.

Principal Findings. There was no difference in medication persistence between groups. CDHP enrollees with the educational outreach were more likely to have converted to lower-cost generic alternative antihypertensive medication compared with CDHP enrollees without the educational outreach (ORadj=29.82, 95 percent CI=4.41–201.93).

Conclusion. Educational outreach directed to CDHP enrollees was associated with increases in lower-cost generic alternatives with no change in patients' chronic medication use. However, considerable opportunity exists to assist CDHP enrollees in making sound health care decisions.

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