Improving adherence to high-value medications through prescription cost-sharing policies

Many countries and health systems are struggling with growing healthcare expenditures in general, and those for prescription drugs in particular. The USA is no exception, with pharmaceutical spending per capita above that of any other Organisation for Economic Co-operation and Development country.1 Cost-sharing through copayments or coinsurance is a common approach to attempt to manage drug spending and utilisation. However, although cost-sharing reduces potentially unnecessary medication use,2 it also reduces adherence to needed medications. Reduced adherence can lead to long-term health detriments and to offsetting costs.3–5 The effects of cost-sharing may be exacerbated among low-income individuals.6 7

Most previous studies of the impact of cost-sharing on adherence have focused on patients who have filled a prescription at least once. In contrast, there are fewer studies focused on adherence to filling the initial prescription. In this issue,...

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