Drug Coverage and Health Outcomes

Does limiting or placing caps on drug insurance coverage result in health care savings? A new analysis by researchers from Brigham and Women’s Hospitals and the CVS Health Research Institute, published in the American Journal of Public Healthsays no. In fact, the authors suggest that broader prescription drug coverage can lead to improved health outcomes and reduce use of other, often costly, health care services.

Prescription Drug Insurance Coverage and Patient Health Outcomes: A Systematic Review

Researchers analyzed 23 studies that investigated prescription drug insurance changes between 1990 and 2013. Across the reviewed research studies, the researchers observed a consistent link between drug insurance and improved patient health status. For example, when drug insurance programs were enhanced or expanded, more patients were able to afford important medications enabling them to access and adhere to prescription medicines for chronic conditions. This, in turn, decreased costly complications and overall health care use, including hospitalizations from unmanaged or under-managed conditions. Several studies also showed a negative impact on patient health outcomes when insurers placed caps on or limited drug benefits.

As policymakers explore ways to control rising health care costs, the authors suggest that strategies, other than limiting drug insurance, be considered.  The results of the analysis show that restricting the availability of prescription drugs or prohibiting access could negatively affect patients’ health and may not produce the expected cost-savings.

CVS Health Research Institute Provides More Evidence that Broader Prescription Drug Coverage Improves Health Outcomes