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Benefits and barriers of prescription drug lists for asthma medications

February 13, 2020

Boston, MA - A new study led by the Harvard Pilgrim Health Care Institute examines the benefits and barriers of Prescription Drug List coverage for preventive asthma medications. The study, "Preventive Drug Lists as Tools for Managing Asthma Medication Costs", appears in the February edition of The American Journal of Managed Care.

As drug manufacturers replace affordable generics with higher-cost name-brand drugs, U.S. families affected by asthma have seen a dramatic rise in the cost of medications. To reduce the financial burden of preventive medications and promote adherence, many insurance companies have introduced Preventive Drug Lists (PDLs). A type of value-based insurance design, PDLs are meant to supplement Health Savings Account-eligible high-deductible health plans (HDHPs) by allowing members to receive selected preventive medications for chronic conditions at low or no cost before meeting their deductible, but little is known about consumer experiences using PDLs.

Researchers conducted a qualitative study to explore PDLs from the perspective of families affected by asthma. The study team interviewed 22 U.S. adults enrolled in HDHPs with PDLs who either had asthma, had a child with asthma, or both. Study results showed that while some members reported financial benefit and increased medication adherence as a result of utilizing PDLs, many experienced barriers to PDL use. Barriers included lack of awareness of the PDL benefit; the exclusion or limitation of certain medications from the PDL; and inconsistency or shifting of PDL benefits.

Overall, researchers found that lack of awareness of members' access to PDLs impedes members' ability to seek out the lowest-cost medications. Employers serve as a source of information about PDLs, but greater outreach by health plans is needed to supplement member education and help facilitate use to maximize benefit.

"Our findings offer reasons to be optimistic that PDLs can help families manage asthma care costs and address disparities in asthma medication adherence," says senior author Alison Galbraith, MD, MPH, Associate Professor of Population Medicine at the Harvard Pilgrim Health Care Institute and Harvard Medical School.

Regarding future directions, lead author, Melissa Gilkey, PhD, Assistant Professor, Gillings School of Global Public Health, University of North Carolina, adds, "Our results suggest that additional research is needed to improve PDL design and to ensure that families are aware of --and make full use of--this benefit."

The Harvard Pilgrim Health Care Institute's Department of Population Medicine is a unique collaboration between Harvard Pilgrim Health Care and Harvard Medical School. Created in 1992, it is the first medical school department in the United States based in a health plan. The Institute focuses on improving health care delivery and population health through innovative research and teaching.

Harvard Pilgrim Health Care Institute

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