CVS study: Adherence shrinks health costs

Pharmacy and health policy advocates endlessly tout the cost-saving 
benefits of improved medication adherence. In January, CVS Caremark put more teeth into that argument with some dramatic new findings that should get the attention of every health plan payer.

Patients with chronic conditions who properly adhere to their drug regimens will save the healthcare system as much as $7,800 a year, CVS researchers concluded after an exhaustive analysis of prescription and medical records. That’s the savings resulting from fewer hospitalizations and emergency room visits for adherent patients with congestive heart failure, according to the study.

Patients with other chronic diseases, such as hypertension and diabetes, also could generate eye-opening savings just by adhering to their prescription therapy, the study found — nearly $4,000 per patient in reduced emergency room visits and acute care incidents.

“Although adherent patients spend more on medications — as much as $1,000 more annually — across the board, they spend significantly less for their overall healthcare costs,” said Troyen Brennan, EVP and chief medical officer of CVS Caremark and a study author.

Company researchers based the study, “Medication adherence leads to lower healthcare use and costs despite increased drug spending,” on a three-year analysis of pharmacy and medical claims data for 135,000 patients with congestive heart failure, diabetes, hypertension and dyslipidemia to determine the direct effect of adherence on costs.

“Particularly important from a policy perspective is the impact of medication adherence on total healthcare spending,” the authors reported in the journal Health Affairs. “Across the board, adherent patients spent significantly less.”

The improved adherence rates generated annual per-person savings of $7,823 for congestive heart failure, $3,908 for hypertension, $3,756 for diabetes and $1,258 for dyslipidemia, researchers found. 

Savings were even more pronounced for Americans ages 65 years and older. “Annual total per-person healthcare savings in the older group were $7,893 for congestive heart failure, $5,824 for hypertension, $5,170 for diabetes and $1,847 for dyslipidemia,” the report noted.

One big factor contributing to those lower costs was a reduced need among drug-compliant patients for the hospital. “Across all conditions, adherence was associated with significantly lower annual inpatient hospital days, ranging from 1.18 fewer days for dyslipidemia to 5.72 fewer days for congestive heart failure,” the authors reported.

For a nation battered by ever-rising health costs, a Medicare and Medicaid health safety net frayed by an unsustainable and out-of-
control cost structure, and a population increasingly alarmed about the exploding national debt, the ramifications of CVS’ study can’t be overlooked. “Almost half of all Americans, approximately 133 million people, live with at least one chronic disease,” the report noted. “Because ongoing use of prescription medication is a key component of treatment for chronic conditions, medication adherence — or making sure that patients take the drugs prescribed for them — is a matter of great importance to policy-makers, insurance plan sponsors, physicians and patients.”

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