Aetna Launching Value-Based Program That Improves Medication Adherence, Cost and Outcomes for Members Who Have Suffered fr

-- A new study from Brigham and Women’s Hospital, Harvard Medical School and Aetna supports next-generation approach --

HARTFORD, Conn.--(BUSINESS WIRE)-- Aetna (NYSE: AET) announced today an evolution in value-based insurance design aimed at preventing a leading cause of the estimated 325,000 recurrent heart attacks that happen each year – failure to take prescribed medications. The new program, Aetna Rx Healthy Outcomes, reduces or eliminates copays for targeted prescription drugs and increases personalized support for members. These steps will help members who’ve experienced a heart attack effectively take the medications proven to improve their health and their chances of avoiding a second heart attack.

The proof is solid

The program was developed based on a prospective, randomized study conducted by Brigham and Women’s Hospital, Harvard Medical School and Aetna that looked at the impact of reduced cost-sharing on medication adherence, on cost and -- for the first time – on health outcomes for a targeted condition. The results of the Post-Myocardial Infarction Free Rx Event and Economic Evaluation Trial were also released today in an article published in the New England Journal of Medicine. The study, supported by research grants from Aetna and the Commonwealth Fund, shows that reducing cost sharing for targeted medications among high-risk members who have suffered a heart attack is a simple and scalable action that can substantially improve adherence and health outcomes, with no added costs.

Remove the barriers, improve the outcomes

“As a cardiologist, I know that optimal clinical outcomes depend on patients following recommended treatments. Today’s cardiac medications are well established in greatly reducing a patient’s chances of having a second heart attack – and living longer. Still, only about 40 percent of patients follow the medication regimen after having a heart attack,” says Lonny Reisman, M.D., F.A.C.C., Aetna’s chief medical officer. “Armed with new and growing evidence about patient behavior, we can help high-risk members address their personal barriers to adherence.”

People stop taking their medications for many reasons including costs, side effects, access, lack of understanding, and cultural barriers. As a result, Aetna Rx Healthy Outcomes delivers a multifaceted approach focused on high-risk members who will benefit from:

  • Early identification that will speed engagement in the program
  • No copay for generic cardiac drugs or reduced copay for preferred branded cardiac drugs -- as early as the first prescription
  • Personal support from Aetna’s pharmacists to help members clearly understand what the prescribed drugs do and how and when to take them; these specialists will also assist members in managing any side effects

Additionally members may have support from nurses within Aetna’s Disease Management program. The nurses can also help address any questions or challenges with the treatment plan including helping to align plans with the members’ cultural values. Aetna’s clinical teams will also work closely with members’ doctors to help members successfully take their prescribed medications and avoid a second heart attack.

A simple step with significant potential

The program will be available January 2013 to commercial self-insured, large customers. Members are expected to have reduced out-of-pocket spending on prescriptions and other health services. Plan sponsors are not expected to experience increases in overall health care costs because of an anticipated reduction in hospitalizations.

“Aetna Rx Healthy Outcomes is a proven program for plan sponsors that can significantly decrease the risk of recurrent heart attack and other vascular events and improve the health of their employees,” Reisman says.

Plan sponsors such as Marriott International and L-3 Communications say they are interested in programs like Aetna Rx Healthy Outcomes that have proven value in improving adherence and health outcomes, without adding cost to the system.

“Enhancing our existing value-based program with Aetna Rx Healthy Outcomes can provide additional, targeted patient support that more effectively influences behavior and leads to better health for our employees who have suffered heart attacks. Helping our employees stay healthy is the best investment,” says Jill Berger, vice president, Health and Welfare, for Marriott International.

Helping employees avert serious health events will also result in fewer disability days, less absenteeism and greater productivity. Aetna Rx Healthy Outcomes is expected to expand to include fully insured plans and other health conditions.

About Aetna

Aetna is one of the nation's leading diversified health care benefits companies, serving approximately 36.3 million people with information and resources to help them make better informed decisions about their health care. Aetna offers a broad range of traditional, voluntary and consumer-directed health insurance products and related services, including medical, pharmacy, dental, behavioral health, group life and disability plans, and medical management capabilities and health care management services for Medicaid plans. Our customers include employer groups, individuals, college students, part-time and hourly workers, health plans, governmental units, government-sponsored plans, labor groups and expatriates. For more information, see


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