Dr Niteesh Choudhry Highlights How HDHPs Can Benefit From VBID

There are desirable and undesirable effects of high-deductible health plans, and the use of value-based insurance design may mitigate adverse effects of these plans, explained Niteesh Choudhry, MD, PhD, associate professor of medicine at Harvard Medical School.

Transcript (slightly modified)

What do we know so far about how high-deductible health plans affect adherence?

So there’s an evolving literature now about high-deductible health plans (HDHPs) and medications. And so the literature is a little bit mixed, but what we know so far is that HDHPs tend to make people shift away from expensive medications to lower-cost medications like generics, which in many cases may be perfectly appropriate. And so that is a very desirable result of a HDHP.

Emerging data from our group is suggesting that the introduction of a HDHP or somebody transitioning to a HDHP also leads to the reduction in the use of essential medications—medications for heart disease, and diabetes, and high cholesterol—and those would be considered adverse effects or things that we would not want HDHPs to do. The magnitude of the effects is actually relatively large, 4-6 percentage points, and those normally translate, especially for evidence-based medications, to clinically meaningful impacts.

So that’s an example of the role of where value-based insurance design for these medications may fit with a HDHP as a method to mitigate the adverse effects of the plans themselves.