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WOONSOCKET, R.I. — The U.S. healthcare system could avoid hundreds of millions of dollars in medical costs if medication adherence rates improved, according to the CVS Caremark "2013 State of the States: Adherence Report" released today.
Drawing on data from the 2012 CVS Caremark pharmacy benefit management book of business, the "State of the States" report projects potential cost-savings within each state by examining medication adherence rates and the use of generic drugs across four common health conditions: diabetes, hypertension (high blood pressure), dyslipidemia (high cholesterol) and depression. The potential cost-savings among the states range from $19 million to $2.1 billion based on state member characteristics.
For the first time, the report also looks at three distinct market segments serviced by CVS Caremark's PBM business — health plans, employer-sponsored plans, and Medicare Part D prescription drug plans — to show differences in adherence across the pharmacy benefit marketplace. An interactive online hub developed in conjunction with the report allows audiences to filter data based on market segment, health condition and adherence measure to gain deeper insight into a specific state or draw comparisons across them.
"This data offers policymakers and the healthcare industry a new look at adherence across geography, health condition and prescription insurance status, and demonstrates the need for increased adoption of interventions that can improve medication adherence in order to advance health outcomes for patients and lessen the cost burden for the healthcare system," said Troyen A. Brennan, MD, MPH, EVP and chief medical officer of CVS Caremark. "We at CVS Caremark use this data to conduct research and develop programs that help patients, providers and insurers improve adherence and lower costs across the board."
While state-specific data is the focus of this report, the data also showed some important overall trends in medication adherence across the country:
- Across all market segments (i.e., health plans, employer-sponsored plans and Medicare Part D plans), patients with depression generally had the lowest adherence rates, while patients with hypertension were most adherent;
- Medicare beneficiaries had the highest adherence rates across the three groups;
- Ninety-day dispensing rates were generally highest among members of employer-sponsored plans; and
- Regional variations were apparent across the groups. The lowest adherence rates for health plan members with diabetes and depression occurred in the Midwest, while the lowest rates for patients with any condition in employer-sponsored plans and Medicare Part D occurred in the South.
Medication nonadherence in the U.S. accounts for up to $290 billion in excess healthcare costs annually. Research shows that interventions, such as pharmacist counseling, are cost-effective and contribute to improved adherence behavior, highlighting the central role that pharmacists and other healthcare professionals can play in helping patients effectively managing chronic diseases. This is demonstrated by the CVS Caremark Pharmacy Advisor counseling program, which provides customized counseling to patients and has been shown to increase adherence rates up to 3.9% and return $3 in savings for every $1 spent on counseling.
"CVS Caremark has industry-leading tools to improve medication adherence and generic utilization to drive down healthcare costs for companies and consumers," said Helena Foulkes, EVP and chief healthcare strategy and marketing officer. "The 'State of the States' report provides insights that enable healthcare professionals and policymakers to understand state-specific nuances that can help improve adherence rates. We hope this report will contribute to the dialogue around how to make that happen."
In addition to the 2013 "State of the States" report, the CVS Caremark Pharmacy Care Research Institute also released "Advancing Adherence and the Science of Pharmacy Care: Volume III," a compendium of adherence research conducted by CVS Caremark and its research partners over the last several years. The publication includes summaries of adherence research on contributing factors, financial impact, interventions and policy considerations.
The CVS Caremark Pharmacy Care Research Institute is focused on advancing the science of pharmacy care through research focused on medication adherence and other clinical pharmacy care topics. As one element of this research, CVS Caremark has been working in a multi-year collaboration with Brigham and Women's Hospital to research pharmacy claims data in order to better understand the factors that influence medication adherence.
A full copy of the CVS Caremark 2013 State of the States: Adherence Report and the research compendium, "Advancing Adherence and the Science of Pharmacy Care" are available at CVSCaremarkFYI.com/adherence.