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Research Letter |

Association Between Narrow Pharmacy Networks and Medication Adherence

Jennifer M. Polinski, ScD, MPH1; Olga S. Matlin, PhD1; Christine Sullivan, MS, MBA1; Michael Gagnon, MS1; Troyen A. Brennan, MD, JD, MPH1; William H. Shrank, MD, MSHS1
[+] Author Affiliations
1Policy Research Group, Enterprise Analytics, CVS Health, Cumberland, Rhode Island
JAMA Intern Med. 2015;175(11):1850-1853. doi:10.1001/jamainternmed.2015.4582.
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This pharmacoepidemiology study assessed medication adherence before and after implementation of narrow insurance networks within commercial drug plans.

In narrow or preferred pharmacy networks, in-network pharmacies negotiate reduced prescription prices with insurance plans. Plans then offer their members reduced cost sharing to incentivize in-network pharmacy use, thereby increasing the network’s prescription volume. In 2014, 75% of Medicare Part D and 70% of exchange plan enrollees were in a narrow or preferred network drug plan. Narrow networks are common in commercial plans as well.1 Concerns have been raised that these networks adversely affect medication adherence owing to reduced geographic access.2,3 Others argue that networks encourage members to establish a pharmacy home where pharmacists can better support adherence and coordinated care.4 We assessed the effect of narrow network implementation on members’ medication adherence. We also examined whether pre-post adherence changes between plans that implemented narrow networks and those that did not were different in the following 2 subgroups: plans with and plans without 90-day prescription programs, which are known to boost adherence. Combined with narrow network implementation, these programs may be associated with synergistic improvements in medication adherence.

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