Patients with certain chronic conditions increased medication adherence when enrolled in health savings accounts with pre-deductible coverage, a study reported in EBRI Issue Brief found.

IRS Notice 2019-45 allows HSA-eligible health plans the flexibility to cover 14 drug classes and other health services used to prevent exacerbation of chronic conditions before meeting the plan deductible. By 2022, there was evidence of a rebound in medication adherence.

"We found that the percentage of enrollees with diabetes using insulin increased 4 percentage points, and the percentage of enrollees with heart disease or diabetes using statins increased by 1 percentage point," the report said. "While the magnitude of the effect may seem small, it is important to remember that when medication adherence fell as a result of the introduction of an HSA-eligible health plan, the magnitude of the declines was relatively small as well. Furthermore, the implied out-of-pocket elasticities of demand are closely aligned with previously published estimates."