Pharmacists and the battle to boost adherence

Two-hundred-ninety billion dollars. That’s the number often thrown around when health experts talk about what medication nonadherence costs patients, insurers, health plan payers and the U.S. economy every year. And of course, dollar estimates say nothing about the impact that nonadherence has on patients and their families in higher chronic and acute disease rates, reduced quality of life and shortened lifespans.

So the failure by patients to take their meds as prescribed is a big deal. And it’s gotten a lot of attention from payers in the last couple of years because it’s one of the most obvious levers to pull as public and private health plan sponsors struggle to get a grip on the astronomical and still-expanding cost of health care in the United States.

Pharmacists, of course, are right in the middle of that effort. Boosting Americans’ adherence to the prescription therapies prescribed by their doctors has become mission critical to many pharmacists, and it’s one of the clearest ways they can contribute directly and measurably to the health system’s massive effort to contain costs.

That’s why it was welcome news when CVS Caremark announced earlier this month that it’s expanding its Pharmacy Advisor program to cover an additional five chronic conditions, including asthma, breast cancer, chronic obstructive pulmonary disease, depression and osteoporosis. As DSN senior editor Antoinette Alexander reports, “The condition-based program alerts pharmacists when patients are not adherent to their medication regimens or have a gap in care, allowing them to intervene with patients and communicate with their physicians in real time.”

Up to this point, Pharmacy Advisor focused on patients with diabetes or cardiovascular conditions. But even with that limited pallet of services, CVS pharmacists have already conducted more than 3.8 million interventions through the service, Alexander reports. They also direct patients with chronic conditions who are enrolled in the program to existing disease management programs where they can find other support resources.

Pharmacy Advisor is about “the coordination of care for individuals living with chronic conditions,” according to Troyen Brennan, EVP and chief medical officer for CVS Caremark. And pharmacists, he said, “play an important role in and understand how critical medication adherence is in supporting their patients.”

Do you agree? And if you’re a practicing pharmacist in a community or hospital setting, or a pharmacy student, how much attention is the adherence issue getting in your workplace or classroom? As always, your feedback is welcome and appreciated.

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