Benefit-based co-pays

Why don't co-pays decrease over time? Most pharmaceutical companies will happily pay for a variety of tactics that extend patients' adherence by even one more script filled. But putting patients on a transparent, tiered payment system could give patients the confidence they need to stick to their medication regimens.

There is evidence that the amount of money patients pay for doctors visits and pharmaceuticals affects the frequency with which they take medication properly. Higher doctor visit fees can raise barriers to compliance (patients may not pick up a needed medication or skip a dosage period), meaning co-payment designs are one policy tool for affecting health care behaviors.

David Nash, a medical professor at Jefferson College, suggests that one option for governments and companies is the adoption of benefit-based co-payment designs. These systems have tiered co-payments where levels depend on the seriousness of the illness, where drugs required to treat chronic conditions and drugs that have strong records of effectiveness have lower co-payments.

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