An extra tier for generics helped the medicine go down (in price)

When member cost share for generics went down, member adherence went up.

September 21, 2018

A sixth tier on the formulary helped some of our Blue Plans with Medicare contracts reduce member cost share for targeted generic drugs. We picked medicines CMS had identified as part of its Star adherence program. Member cost share changed from $4 or more to $0-$2 per 30-day supply. Adherence improved for the drugs that treat high blood pressure (1.4 percentage points), cholesterol (1.5 percentage points) and diabetes drugs (1.4 percentage points).

Can Lowering Generics Member Cost Share Impact CMS Star Adherence Metrics? (2018)

Related news

Perspectives

September 14, 2023

Cheers to 20 years and another amazing Specialty Summit!

The 20th annual Specialty Summit hosted by Prime and Magellan Rx returned to…

Perspectives

September 8, 2023

October 2023 decisions expected from the FDA

At Prime Therapeutics (Prime), we’ve positioned ourselves to best prepare our clients to…

Perspectives

August 28, 2023

Specialty Drug Pipeline Monthly Update: August 2023

This monthly pipeline wrap-up provides a review of newly approved specialty drugs, recent…