Study: Auto-refill option before receiving Rx improves adherence

WOONSOCKET, R.I. Preliminary findings from ongoing research on how consumers make healthcare choices indicated that if a patient is proactively presented with an option to select automatic versus manual refills before they fill a prescription, they are twice as likely to choose the automatic option than those who are asked after receiving the prescription, CVS Caremark revealed during a presentation on Wednesday at a communications symposium sponsored by the Centers for Disease Control and Prevention in Atlanta.

Punam Anand Keller, a faculty member at the Tuck School of Business at Dartmouth College, and Bari Harlam, CVS Caremark SVP, made the presentation during Wednesday's symposium. Keller is a member of CVS Caremark's Behavior Change Research Partnership.

According to Keller, new research by CVS Caremark seeks to address the fact that many healthcare decisions unnecessarily are complicated by the lack of clear and plain language. In addition, choices for such programs as automatic refill of prescriptions or generic alternatives can be overlooked because those options are not readily transparent to the consumer, Keller noted.

"Through this research we are testing options presented through four different communications channels to see how consumers react to different scenarios," Keller said. "One of our preliminary findings looking at consumers on the Web shows that if we reach out and present a decision to choose automatic refill in advance of renewing a prescription, they sign up at twice the rate of those who were passively presented an opt-in choice after receiving a prescription."

The BCRP is calling the proactive test "Active Choice." CVS Caremark is testing Active Choice in four communication channels:

  • Interactive Web sign-ins
  • During in-bound customer calls to care centers
  • Through automated outbound telephone calls
  • Through direct mail

Results for how consumers react in all four channels are not complete; however, Keller said the test using Web-based tools includes an automatic pop-up box that poses the question in clear language before a prescription is filled. The volume of automatic refill requests through that scenario was double the rates the company previously saw.

CVS Caremark launched the BCRP last March to study ways behavioral economics might impact healthcare decisions, and to better understand why some patients stop taking chronic illness maintenance medications prescribed by their doctors. Besides Keller, other behavioral economists participating on the BCRP are George Loewenstein from Carnegie Mellon University and Kevin Volpp from the University of Pennsylvania's Medical School and The Wharton School of Business.

The ongoing work is focusing on how different communications can encourage consumers to stay on their medications and offering automatic refills -- the focus of the Active Choice review -- is one way to encourage adherence.

Keller said the BCRP work on the Active Choice option is continuing, and like other CVS-sponsored studies, the BCRP plans to publicly share the findings in the interest of encouraging better understanding of adherence issues throughout the industry.

"We are looking at this issue from all angles because it is well-known that medication nonadherence is costing the healthcare system billions of dollars every year because people who stop taking medications may face unnecessary hospital admissions and other healthcare expenditures," stated Troyen Brennan, EVP and chief medical officer of CVS Caremark. "Our plan is to develop innovative programs that encourage adherence because good pharmacy care is among the most cost-effective healthcare options."

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