Does the cost sharing structure encourage medication adherence?

Employers are encouraging medication adherence by reducing or eliminating co-payments and co-insurance for diabetes related medications.

• Click on this link to an article that appeared in the American Journal of Managed Care to learn more about the Pitney Bowes approach to pharmacy benefit design.
• MHealthy: Focus on Diabetes is a program that eliminates or reduces the cost of selected medications for University of Michigan employees and dependents who have diabetes. The two-year pilot program began on July 1, 2023 and encourages the proper and sustained use of specific drugs that affect blood sugar, blood pressure, cholesterol and depression and help prevent or reduce the long-term complications of diabetes. For more details about this program, see www.hr.umich.edu/mhealthy/improve/diabetes.html.

What diabetes-related medications and blood sugar monitoring devices (name brand or generic) does the health plan cover?

Annual out-of-pocket costs for diabetes-related medications and blood sugar monitoring devices can be high, depending on the pharmacy benefit that the health plan offers. When evaluating a health plan's benefits, carefully review the list of medications and supplies (sometimes called a formulary) it covers to be sure the list meets your current and potential needs. Ask the plan how often it reviews, adds, subtracts, or changes this list. Plans with mail order prescription services may save members time and energy.