CVS Caremark research: Rx adherence can spell cost savings for coronary artery disease patients

WOONSOCKET, R.I. — Patients with coronary artery disease who are adherent to their prescribed medications can save the healthcare system up to $868 per patient per year, according the findings of a recent study conducted by researchers at Brigham and Women’s Hospital and CVS Caremark.
The research was published in the April issue of the American Journal of Medicine.

Heart disease costs the United States $108.9 billion each year, according to the Centers for Disease Control, but there are ways those costs can be controlled. The study found a consistent trend toward improvement in coronary artery-related events, mortality, re-admissions and costs among those patients who most adhered to their medication regimens.

"Managing rising healthcare costs is the most pressing issue facing our health care system today," stated Troyen Brennan, EVP and chief medical officer of CVS Caremark. "This study affirms a consistent trend we have seen in research regarding the positive effect of improving medication adherence. Patients with chronic conditions are healthier when they adhere to their prescribed medication regimens, and as a result, the costs associated with their care are reduced."

In the study, titled "The Impact of Medication Adherence on Coronary Artery Disease Costs and Outcomes: A Systematic Review," the researchers reviewed more than 2,500 studies published between 1966 and 2011, analyzing the 25 studies that met the inclusion criteria related to adherence and coronary artery disease outcomes. A subset of the studies measured the impact of medication adherence on primary prevention of CAD, and the remainder focused on the relationship between medication adherence and costs and outcomes related to secondary prevention of the disease. All of the studies reviewed found that adherence significantly improves health outcomes, and those that analyzed costs found reduced total annual CAD costs (consistently between $294 and $868 per patient).

While the study found consistent outcomes in cost reductions and health improvements related to better medication adherence, the researchers also identified an opportunity for greater standardization and improved research methods across medication adherence studies. The authors pointed out that many of the studies they reviewed did not account for what they refer to as the "healthy adherer" effect, noting that few of the studies they analyzed controlled for predisposed healthy behaviors in the patients that were followed.

"The research community has long believed that those patients who adhere to their medications may also be more likely to pursue a healthier lifestyle," stated Asaf Bitton, lead author of the study affiliated with the Brigham and Women's Hospital Division of General Medicine and the Harvard Medical School Center for Primary Care. "The next step from a research perspective would be to find a consistent way to control for the effect of these 'healthy adherers' to provide a more accurate picture of adherence for future studies and to further advance the research science in this field."

CVS Caremark has been working in a multiyear collaboration with Harvard University and Brigham and Women's Hospital to research pharmacy claims data in order to better understand patient behavior, particularly around medication adherence. Annual excess healthcare costs due to medication nonadherence in the United States have been estimated to be as much as $290 billion annually.

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