WOONSOCKET, R.I. — CVS Caremark issued on Tuesday two new reports that highlight research the company is conducting around medication adherence, including one study that reviews and compares state-by-state adherence rates for patients managing four chronic diseases.
“These reports are part of our continuing effort to shine a bright light on the issue of adherence so that patients, pharmacists, physicians and policy-makers understand why patients taking their medications as directed can improve the quality and lower the cost of health care,” stated Helena Foulkes, EVP and chief healthcare strategy and marketing officer of CVS Caremark.
"The State of the States: Adherence Report" looks at how patients in all 50 states are complying with their doctors’ orders about taking medication. The review of CVS Caremark’s PBM claims data focused on four common disease states — hypertension, high cholesterol, diabetes and depression — diseases that make up a large portion of pharmacy spend by health plan sponsors.
The second report, "Advancing Adherence and the Science of Pharmacy Care Volume 2," is a compendium outlining research resulting from a collaboration CVS Caremark has been conducting with Harvard University and Brigham and Women’s Hospital over the past three years to explore why a significant portion of patients do not take their medications as directed.
Troyen Brennan, EVP and chief medical officer of CVS Caremark, who heads the research initiative, said, “The research we have been conducting provides important information to those looking for ways to make the healthcare system more affordable and accessible. Medication adherence is unique because it gives us a real opportunity to improve patient health while lowering the overall cost of care.” "The State of the States: Adherence Report":
Reviews de-identified data from the CVS Caremark pharmacy benefit management book of business across all 50 states to see how patients in different geographies (and potentially different plan designs) are complying with their doctor’s directions about taking medications;
Examines claims data for four common chronic diseases: hypertension, high cholesterol, diabetes and depression. These four diseases were reviewed because more than half of U.S. citizens suffer from at least one chronic disease, and the treatment for chronic disease represents more than 75% of our nation’s healthcare costs; and
Applies a definition of adherence that weighs medication possession ratio, first-fill persistency rates, the percent of generic prescriptions dispensed and the percent of prescriptions that are dispensed through mail. Weight is applied to generic dispensing rates because several CVS Caremark research studies have found that the cost of medications is a consistent barrier to medication adherence. Weight is applied to mail-order dispensing rates because CVS Caremark and other research has found that once pharmacies get patients past the important transition of people moving from retail to mail, patients using mail order have higher adherence rates.
“We plan to share the 'State of the States: Adherence Report' widely, with state and regional officials and directly with policy-makers in all states. We will also use this information to inform discussions we have with our clients about identifying ways to improve adherence rates for their plan members. We hope by convening these discussions around adherence, we can convince policy-makers to make the goal of improving medication adherence a national priority,” Foulkes stated. "Advancing Adherence and the Science of Pharmacy Care, Volume 2":
Outlines findings from 20-peer reviewed articles in medical, pharmacy care and economic journals on different aspects of adherence. The studies include recommendations for changing healthcare practices that can improve patient medication-taking behaviors; and
Summarizes research that discusses the financial impact of adherence, contributing factors to nonadherence, the role of healthcare professionals in working with patients to improve medication-taking behavior and the role technology can play in improving patient care.
“Our investment of money and time researching this issue is significant. We have brought the nation’s top research talent to the task,” Brennan stated. “The work is helping us engage patients to help them make appropriate decisions about their health. We are also using it to educate the public about the importance of staying adherent to prescription medications.”
The issue of medication nonadherence is a major public health issue. Experts place the annual excess healthcare costs resulting from medication nonadherence in the United States to be $290 billion.
CVS Caremark intends to share results from the collaboration so providers can develop tools to predict and target those patients who are at risk for nonadherence and prescription abandonment. The future work will focus on finding appropriate pharmacist interventions that will improve care mechanisms that will help healthcare providers simplify regimens for those with the most complex therapies, improve pharmacist and healthcare-provider communications with patients. In addition, Brennan said, the research also will look at social networks as healthcare tools, patient safety issues, comparative effectiveness and ways to simplify patient medication regimens, all of which aim to improve patient medication-taking behavior.