Cutting drug prices to consumers is not enough to encourage greater compliance by patients on chronic medication, a new US study has reported.

Reducing patient co-payments resulted in just a 2.5 percentage pint increase in patients’ compliance with their prescribed cholesterol-lowering statins, according to new findings from researchers at US pharmacy benefit manager (PBM) Express Scripts.

In terms of assessing what works best for consumers as they make health decisions, these findings suggest that health plan sponsors might want to consider other incentives other than financial ones, such as customized patient communications, said Emily Cox, Express Scripts‘ senior director of research. “They should also consider tools to encourage greater use of home delivery pharmacy where patients save money and where recent findings suggest better compliance," she added.

Another study by Express Scripts earlier this year found that compliance was seven percentage points higher for patients taking medications to treat high cholesterol when they used a home delivery pharmacy instead of a retail pharmacy. The overall effect of home delivery was much greater than lowering copayments in terms of increasing compliance.

"Patients had a much smaller reaction to lowering co-payments than the reaction to increasing co-payments. This finding might seem surprising initially, but it demonstrates a reality that behavioral economists see every day," said Dr Cox.
Greater response to co-payment increases than to decreases is supported by a well-documented principle of behavioral economics: aversion to losses. Under this theory, patients have a more pronounced demand response when required to increase their contribution as opposed to when they pay less than their usual cost.

"For consumers, losses loom larger than gains when it comes to making decisions," commented Dr Cox.

- Earlier this week, new research published in the journal Health Affairs concluded that reducing drug co-payments by 20% would increase US life expectancy by about 0.5 years by 2060, as a result of improving public health through the greater use of medicines and encouraging medical innovation.