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WASHINGTON — Amid mounting evidence of the negative clinical and economic consequences of medication nonadherence, research featured on the cover of this month’s Health Affairs breaks new ground by urging innovative approaches to improve medication adherence and to “achieve a higher-performing health system.”
The researchers analyzed data for patients with diabetes, heart failure and chronic obstructive pulmonary disease who were enrolled in the Medicare Part D prescription drug program. The report found that poor medication adherence was associated with additional medical and hospital visits resulting in added cost that ranged as low as $49 and as high as $840 per beneficiary per month.
In addition to gauging potential Medicare cost-savings by improving medication adherence, the study evaluated the criteria by which Medicare Part D beneficiaries are deemed eligible for medication therapy management. “By combining the two methods, we produce a new metric, ‘potentially preventable future costs,’ that can be used to target medication therapy management interventions to at-risk beneficiaries with the aim of both improving the quality of care and reducing unnecessary Medicare expenditures,” noted Bruce Stuart, one of the study's authors and professor in the department of Pharmaceutical Health Services Research and director of the Peter Lamy Center on Drug Therapy and Aging, University of Maryland School of Pharmacy.
The Medicare Prescription Drug, Improvement, and Modernization Act of 2003, which established the Part D benefit, requires plans to offer MTM services to beneficiaries with multiple chronic conditions who are taking multiple different medications and have high annual drug spending. However, under current eligibility criteria only a small share of beneficiaries qualify to receive these services.
“We believe that potential costs averted should be considered as a criterion for targeting [MTM] interventions and that attention therefore should be given to beneficiaries now excluded from review who display suboptimal adherence patterns associated with the highest Medicare costs,” wrote Stuart.
They urged that improving medication adherence “offers one of those rare opportunities in health care to achieve multiple desirable endpoints from the same policy.”
The other authors included Ellen Loh, graduate research assistant at the University of Maryland, Pamela Roberto, senior director, Pharmaceutical Research and Manufacturers of America, and Laura Miller, senior economist, National Association of Chain Drug Stores.