The Pharmaceutical Research and Manufacturers of America (PhRMA), in a lengthy study aimed at discovering and developing ways for patients to live longer, healthier and more productive lives, concluded that successful treatment of disease with prescription medicines requires consistent use of the medicines as prescribed.
Yet research shows that medicines commonly are not used as directed. Non-adherence to medicines is a major health care cost and quality problem, with numerous studies showing high rates of non-adherence directly related to poor clinical outcomes, high healthcare costs, and lost productivity. The cost of non-adherence has been estimated at $100 billion to $300 billion annually, including costs from avoidable hospitalizations, nursing home admissions, and premature deaths.
Adherence to therapy is especially important for management of chronic diseases, such as diabetes, heart disease and cancer. Chronic disease affects nearly one in two Americans and treating chronically ill patients accounts for $3 out of every $4 spent on medical care. In a supporting recent commentary, Harvard University researchers found that poor adherence among patients with chronic conditions persists despite conclusive evidence that medication therapy can substantially improve life expectancy and quality of life.
The solution to this problem, the study proposed, lies in efforts to stimulate better prescribing of and adherence to essential medications that will increase value by improving population health, averting costly emergency department visits and hospitalizations, and improving the quality of patients’ lives.
Improving medication adherence holds great potential to contribute to better health outcomes and more effective chronic care management. In the private sector, forward-looking employers are taking steps to improve adherence, particularly among workers with chronic illnesses.
In Medicare and Medicaid, improved adherence can be pursued through Medicare Part D medication therapy management programs, care transition medication reviews focused on high-risk beneficiaries, utilizing medication therapy management services, greater adoption of health information technology and more robust electronic exchange of information through the EHRs.
Many of these initiatives include quality targets likely to require improved medication adherence. These initiatives will play well in the new value-based care environment. Efforts to improve adherence represent win-win solutions in which patients, employers, insurers and the public all benefit.