CVS Caremark Corp. may be onto something based on early findings from its ongoing behavioral research on consumer health care choices.

CVS Caremark, auto refill, automatic refills, prescription, Behavioral Change Research Partnership, Active Choice, Russell Redman, Centers for Disease Control, Punam Anand Keller, Tuck School of Business, Dartmouth College, Bari Harlam, medication adherence, Carnegie Mellon, University of Pennsylvania, Wharton School, Harvard University, Harvard and Brigham and Women's Hospital, Troy Brennan, Minds At Work,

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CVS finds asking beforehand spurs auto refill

August 18th, 2010

WOONSOCKET, R.I. – CVS Caremark Corp. may be onto something based on early findings from its ongoing behavioral research on consumer health care choices.

The company said Wednesday that through its Behavioral Change Research Partnership, announced in March, it found that if consumers are asked to select automatic refills versus manual refills before they fill a prescription, they are twice as likely to pick the automatic option than those given the choice after receiving the prescription.

Those findings were presented on Wednesday at a communications symposium sponsored by the Centers for Disease Control in Atlanta, by Punam Anand Keller, a faculty member of the Tuck School of Business at Dartmouth College, and Bari Harlam, senior vice president at CVS Caremark. Keller is a member of the Behavior Change Research Partnership, whose other participants include Dartmouth's Tuck School, Carnegie Mellon University, and the University of Pennsylvania's Medical School and Wharton School of Business .

According to Keller, the new research by CVS Caremark seeks to address the fact that many health care decisions are unnecessarily complicated by the lack of clear, plain language. What's more, choices for programs like automatic refill or generic drug alternatives may be overlooked because they are not obvious to consumers.

"Through this research, we are testing options presented through four different communications channels to see how consumers react to different scenarios," Keller said in a statement. "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."

CVS Caremark said the partnership is calling the proactive test Active Choice, which is being tested through interactive Web sign-ins, in-bound customer calls to care centers, automated outbound telephone calls and direct mail.

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

The Behavioral Change Research Partnership is studying ways that behavioral economics may impact health care decisions and to better understand why some patients stop taking their prescribed maintenance medications for chronic illness. Besides Keller, other leading behavioral economists in the effort include George Loewenstein of Carnegie Mellon and Kevin Volpp of the University of Pennsylvania.

The research, CVS Caremark noted, is focusing on how different communications can encourage consumers to stay on their prescriptions, and offering automatic refills is one way to encourage medication adherence. 

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

The company reported that past industry studies show one-quarter of people receiving prescriptions never fill their first prescriptions, and patients with chronic diseases such as diabetes and coronary artery disease adhere to their ongoing medication regimen about half of the time.

CVS Caremark also has been involved in other research efforts regarding medication adherence. In a study the company commissioned with Minds at Work, a Cambridge, Mass.-based firm founded by Harvard University psychologists, it examined what motivates people to stop taking their medicine. And the drug store and pharmacy benefit management company has formed three-year collaboration with Harvard and Brigham and Women's Hospital to research pharmacy claims data to better grasp patient behavior around medication adherence.