UPMC Health Plan
Pittsburgh (Nov. 18, 2020) – UPMC Health Plan and Sempre Health today announced the expansion of their highly successful medication adherence affordability collaboration to now include diabetes medicines. Launched in 2017, the program, which uses SMS messaging to provide discounts for cardiovascular medications, has saved participating UPMC Health Plan members more than $500,000, with the average member saving $33 per prescription refill. Based upon this success, UPMC Health Plan and Sempre Health are expanding the program to include diabetes medications for members of UPMC Health Plan’s fully insured employer group plans, as well as self-insured employer group plans that do not opt out of this coverage. Members eligible for the expansion program will be able to begin enrolling in November, just in time for National Diabetes Month.
“We are expanding this program to cover nearly all of our branded formulary preferred diabetes medications because we know that medications for chronic disease can sometimes place an ongoing financial burden on patients,” said Chronis Manolis, RPh, chief pharmacy officer at UPMC Health Plan. “We’re excited to build upon the strong outcomes of this program to date. With this expansion of the program, members are empowered to drive down their costs and over time improve their health outcomes.”
In the US, nearly one-third of patients say they have not taken their medicine as prescribed due to costs—a bleak statistic especially given the impact that cost-related nonadherence can have on health outcomes.¹ Under this program, when participating members fill their eligible prescriptions on time, they will receive discounts on their copayments. Early results from the UPMC Health Plan and Sempre Health partnership show that this novel discount model results in significant improvement in member engagement and increased adherence to the medication.
During the first year of the UPMC Health Plan and Sempre Health partnership, the program successfully enrolled more than one-in-three eligible members and led to significant improvements in adherence versus a control group. Additionally, the natural language text reminders and conversations with members led to increased engagement by creating a personalized and concierge experience for those enrolled.
“Patients who consistently follow their doctor’s orders by filling their prescriptions on time and taking their medications as prescribed are rewarded with Sempre’s dynamic discounts on their copay—amounting to a ‘good driver discount' for healthcare,” said Anurati Mathur, CEO of Sempre Health. “Our growing partnership with UPMC Health Plan enables patients across Pennsylvania to share in the savings they generate when making healthy decisions. We’re excited to build upon our strong outcomes to date and further improve medication affordability and access for the UPMC Health Plan members who need us most.”
About the UPMC Insurance Services Division
Serving more than 3.9 million members, UPMC Insurance Services is owned and operated by UPMC, a world-renowned health care provider and insurer based in Pittsburgh, Pa. UPMC Insurance Services includes commercial products from UPMC Health Plan for groups as well as individuals. Commercial products also include workers' compensation and employee assistance from nationally known Workpartners. Government products include Medicare Advantage (UPMC for Life); special needs plans for those eligible for Medicare and Medical Assistance (UPMC for Life Complete Care and UPMC Community HealthChoices); Medical Assistance (UPMC for You); and Children's Health Insurance Program (UPMC for Kids) ; and Community Care Behavioral Health, one of the nation's largest managed care behavioral health organizations. For more information, visit www.upmchealthplan.com.
About Sempre Health
Sempre Health works with leading health plans and pharmaceutical companies to reduce the cost of copayments for patients who refill their prescriptions on time. By combining technology, behavioral science and dynamic pricing, Sempre Health aims to boost all of its members' medication adherence to exceed 80 percent of days covered -- the widely acknowledged gold standard. Doing so will dramatically improve the health of millions of people and save hundreds of billions of dollars in avoidable medical costs. For more information visit www.semprehealth.com.
¹Henry J Kaiser Family Foundation: KFF Health Tracking Poll – February 2019: Prescription Drugs (www.kff.org/health-reform/poll-finding/kff-health-tracking-poll-february-2019-prescription-drugs)