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

November 18, 2022

Traditional Drug Pipeline Quarterly Update: November 2022

This quarterly pipeline wrap-up provides a review of newly approved traditional drugs, recent…

Perspectives

November 15, 2022

Three Minutes with Mitchell Scott

Mitchell Scott is Senior Director of Prime’s Special Investigations Unit (SIU) and Pharmacy…

Perspectives

November 11, 2022

December 2022 decisions expected from the FDA

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