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A75oral anticoagulation were enrolled in plans with fixed or percentage medication copayment structures. Endpoints included medication persistence; > 1 ER visits, hospitalization, number of ambulatory visits; and total all-cause healthcare cost. Multivariable regression analysis estimated effect of benefit design parameter, adjusting for baseline characteristics. Results: The integrated database included 36,475 patients with T2DM, 7,986 IM, and 6,391 AF. Overall, the majority had a fixed copayment plan; a 3-tier plan was most common (92.7%). By therapeutic area, fixed copay pharmacy benefit for T2DM, IM and AF were 83%, 86% and 76%. Higher 3rd tier copayment was associated with poorer persistence in T2DM and a trend in AF, but not IM. Higher 3rdtier copayment increased adjusted risk of > 1 ER (T2DM), > 1 inpatient (T2DM), and ambulatory (T2DM, IM), visits. Comparison of patients with a fixed copayment versus coinsurance plan found that a fixed plan was associated with higher adjusted persistence (T2DM) and total all-cause healthcare costs (T2DM, IM, AF). ConClusions: Medical and pharmacy claims linked to pharmacy benefit design data are useful to evaluate select outcomes across multiple TAs, and allow evaluation of patient burden once treatment is initiated. However, sample size varied by TA and the relatively smaller percentage of coinsurance patients did not allow robust comparisons. Additional information from the medical record is needed to better understand adherence and persistence.