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Narrow pharmacy networks may promote higher prescription compliance


Health care consumers enrolled in drug benefit plans with narrow pharmacy networks are more likely to take their prescription medicines, a new study finds.

Contrary to concerns that narrow pharmacy networks discourage patients from sticking with medication therapies because of reduced access, a CVS Health Corp. study published Thursday in the journal JAMA Internal Medicine found that patients in commercial drug plans with narrow pharmacy networks showed improved medication adherence.

“There are few opportunities in health care when we can improve both quality of care and health outcomes while helping to manage health care costs,” Dr. William H. Shrank, senior vice president and chief scientific officer of CVS Health, said Thursday in a statement accompanying the findings. The “study suggests that narrow networks may be one such opportunity by providing clear evidence that these networks — already an established cost management strategy — also help optimize members' adherence,” he said.

Narrow and preferred pharmacy networks have become a prevalent employer strategy to reduce pharmacy costs, CVS Health said in the statement. Employers provide incentives for their workers to use the in-network pharmacies, which negotiate with insurers for reduced prescription prices for plan members in exchange for increased prescription volume, CVS Health said.

Researchers analyzed CVS Health pharmacy benefit manager data for more than 200,000 patients on chronic therapies to treat high cholesterol, high blood pressure, diabetes and depression for a 12-month period in 2012 and 2013. Nearly 68,000 patients were enrolled in narrow pharmacy network plans, while nearly 150,000 were not.

Researchers compared prescription data before and after implementing a narrow network plan.

By analyzing the patients' medication possession ratio, which measures their available medication on hand over time, CVS Health found that although both narrow network and non-network plans showed increased adherence during the time period, patients enrolled in narrow network plans showed greater improvement in medication adherence for all conditions.

For example, patients in narrow network plans being treated for diabetes in 2013 took their medication 77.3% of the time, compared with 76.0% in 2012 before a narrow network was implemented, the study found.

For non-network plans, in 2013 patients adhered to their anti-diabetic medication 80.2% of the time, compared with 79.8% the previous year.

“Despite common concerns that narrow pharmacy networks reduce access, we believe they can actually help encourage plan members to establish a pharmacy home where patients with chronic diseases can receive coordinated care and effective medication adherence support,” Dr. Shrank said.