Tulane University


Louisiana Experiment Assessing Diabetes: Zero Dollar Copayment (LEAD-ZDC)


Non-adherence to prescribed antidiabetic medications, antihypertensives, and statins is associated with poorer glycemic control, increased risk of complications, and greater healthcare costs..  While there are various reasons patients are non-adherent, one of the primary reasons is because they cannot afford their medications. Cost-related nonadherence has been closely linked to social determinants of health including food insecurity and financial burden.  Blue Cross and Blue Shield of Louisiana has instituted a value-based benefit design with zero-dollar copayments for a prescription medication list, for its fully insured members.  This study will evaluate the effects of the zero-dollar copayment program on medication adherence, rates of diabetes complications, health care utilization and patient-reported outcomes. Additionally, the study will examine barriers and facilitators influencing how the program is implemented and received by patients and health care providers.  Lastly, these analyses will examine the short-term cost-effectiveness of the zero-dollar copayment program from both the health system and societal perspective and will use simulation approaches to model the cost-effectiveness over a 40-year time period.

Dr. Lizheng Shi
Dr. Beth Nauman

Medication treatment non-adherence is prevalent and costly in diabetes management where cost-related non-adherence with medication therapies has to be addressed as part of the social determinants of health. - Dr. Lizheng Shi, PhD, MsPharm, MA, Principal Investigator and Dr. Beth Nauman, PhD, MPH, Co-Investigator of Tulane Team