Evaluation of Emails Promoting Mail-order Pharmacy

Geisinger Health

Status: Completed

Conditions: Health Care Utilization

Treatments: Behavioral: Highlighting Cost Savings and Convenience; Behavioral: Comparison Table; Behavioral: Endorsement from a Doctor; Behavioral: Fear Appeals; Behavioral: Message about Future Healthcare Costs

Study type: Interventional

Funder types: Other

Identifiers

NCT04587063

2020-0482

Details and patient eligibility

About

In this evaluation, four versions of emails will be sent to eligible health plan members who are not currently enrolled in the health system's mail-order pharmacy. A control group will not receive any communication. The researchers hypothesize that the use of content informed by behavioral nudge theory in the emails should lead to increased enrollment in the health system's mail-order pharmacy.

Full description

The utilization of a mail-order pharmacy can increase adherence to medications. The health system's mail-order pharmacy (from here, simply referred to as mail-order pharmacy) can also provide reduced costs for medications. Ongoing outreach efforts involve sending emails and other communications encouraging enrollment in Geisinger's mail-order pharmacy to eligible members of the system's health plan (i.e., those who take maintenance medications). The study will compare a standard promotional email from these outreach efforts, as well as three new emails with content informed by behavioral science research, against a no-contact control arm and each other.

Enrollment: 5,266 patients

Sex: All

Ages: 18+ years old

Volunteers: Accepts Healthy Volunteers

Inclusion criteria

• An active member of the health plan (Medicare, Commercial, or Exchange)
• Currently prescribed maintenance medications
• Not currently subscribed to the health system's mail-order pharmacy
• Has an email on record

Exclusion criteria

• Explicitly opted out of receiving emails from the health system
• Only has eligible current prescriptions for fewer than 28 days
• Only has prescriptions that cannot be sent via mail-order pharmacy (e.g., antidepressants, specialty-tier drugs)
• Is a Medicare member in the coverage gap
• Shares an email address with another selected participant (who was randomly chosen for inclusion among all those sharing the same email address)

Trial design

Primary purpose: Health Services Research

Allocation: Randomized

Interventional model: Factorial Assignment

Masking: Double Blind

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5,266 participants in 5 patient groups

Standard Email

Active Comparator group

Description:

The "standard of care" email is the same as one used in prior outreach efforts at the health system, emphasizing reduced cost for medications and convenience.

Treatment:

Behavioral: Highlighting Cost Savings and Convenience

Email with Healthcare Cost Savings

Experimental group

Description:

The email emphasizes future reductions in healthcare costs due to increased adherence with mail-order pharmacy, in addition to mentioning reduced prices for medications. It also uses fear appeals by stating the risk of hospital stays and how mail-order pharmacy could be an easily-achievable way to avoid this negative consequence.

Treatment:

Behavioral: Highlighting Cost Savings and Convenience

Behavioral: Message about Future Healthcare Costs

Behavioral: Fear Appeals

Email with Endorsement

Experimental group

Description:

The email is a letter from a doctor at the health system's health plan--who may been seen as a trusted source of information--encouraging the benefits of using a mail-order pharmacy.

Treatment:

Behavioral: Endorsement from a Doctor

Behavioral: Highlighting Cost Savings and Convenience

Email with Comparison Table

Experimental group

Description:

The email includes a table comparing the benefits and drawbacks of mail-order and chain pharmacies, which appeals to their sense of agency and allows them to make the choice that best suits them.

Treatment:

Behavioral: Highlighting Cost Savings and Convenience

Behavioral: Comparison Table

No Contact

No Intervention group

Description:

Members do not receive an email.