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CVS Caremark-sponsored review of e-Rxs uncovers issue of primary nonadherence

BY Antoinette Alexander

WOONSOCKET, R.I. — Twenty-four percent of patients given a new medication by their doctor did not fill the prescription, according to a new study by researchers at Harvard University, Brigham and Women’s Hospital and CVS Caremark.

The newest CVS Caremark-sponsored study, which was published this week in the American Journal of Medicine, evaluated more than 423,000 electronic prescriptions written in 2008 by 3,634 doctors for more than 280,000 patients from all 50 states. The study team matched the e-prescriptions with resulting claims data, or in the case of those not filling the prescription, used the lack of a claim within six months to identify primary nonadherence.

Most prior research of patients who do not take medications as prescribed looked at patient behavior after filling a first prescription. The advent of e-prescribing provides the opportunity to track initial prescriptions that previously may have been undetected and gives healthcare providers a broader look at patients who never fill their new prescriptions, the study authors noted.

"When patients don’t take their medications, especially for chronic conditions, they miss an opportunity to improve their health and avoid long-term complications," stated Michael Fischer, of Brigham and Women’s and Harvard Medical School, the lead author of the study. "While some recent research has used e-prescribing data to evaluate primary nonadherence, we were able to study a nationwide sample of patients. Our finding that 24% of patients are not filling initial prescriptions reflects slightly higher primary nonadherence than seen in earlier studies."

"CVS Caremark is looking at this issue from every angle," added Troyen A. Brennan, EVP and chief medical officer of CVS Caremark, and a study co-author. "This study reviewed factors that might cause patients to ignore that first fill, so we can arm health care providers with information to proactively address the problem."

Among the factors highlighted by the researchers as predictive of primary nonadherence are:

  • The out-of-pocket cost of medications: Patients who received prescriptions for medications that were not included on their health care formulary — and were therefore more expensive because co-pays would be higher — are more likely not to fill their first prescription;

  • The integration of the doctors’ health information systems: Prescriptions directly sent to pharmacies or mail-order systems are more likely to be filled than e-prescriptions that doctors print out and give to patients;

  • Socioeconomic factors: The researchers determined by reviewing ZIP codes and census data that patients who live in higher income areas are more likely to fill prescriptions for new medications; and

  • The type of medications: Prescriptions written for infants are almost always filled and antibiotics are filled at a rate of 90%. Medications for hypertension or diabetes saw primary non-adherence rates in excess of 25%.

This latest study is another result of a three-year research collaboration between CVS Caremark, Brigham and Women’s Hospital, and Harvard that aims to develop a better understanding of patient behavior, with a special focus on medication adherence.

Annual excess healthcare costs due to medication nonadherence in the United States are estimated to be as much as $300 billion annually.


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Nov-28-2012 11:43 pm

Technology makes it everything possible. Its really one of the best thing that technology has offered for us. Thank you for the informative share. Dr. Emil Hawary Reviews

M.Sherman says:
Oct-31-2011 10:37 am

I believe the answer is simple.Community pharmacists MUST be utilized to the maximum and compensated for counseling patients. Pharmacists should sit down and consult with patients, so the patient fully understands everything about their medication and the reason for taking it. Good relationships between the pharmacist and patient and reinforcement on adherence issues result in positive outcomes for the patient and ultimately a decrease in healthcare costs. Community pharmacists and not the mail order mill will ultimately improve adherence and lower costs, thus benefiting the patient, the pharmacist and the health care system Michelle J Sherman, RPH,FASCP,AAHIVE MichRx Pharmacist Consulting Services, Inc. www.MichRxConsulting.com www.MichRx.com

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Robitussin taps Peggy Fleming for new campaign

BY Allison Cerra

MADISON, N.J. — Robitussin has launched a new campaign in line with the start of the cold and flu season called the Simple Acts of Relief program.

As part of the program, Robitussin has tapped Olympic medalist Peggy Fleming for its Last Names Giveaway. Through the Last Names Giveaway, the brand is making an exclusive offer to people whose last name is (or sounds like) one of the cold symptoms Robitussin treats. The first 5,000 eligible entrants, which can submit their names at SimpleActsofRelief.com, will receive free Robitussin to help get them through this cold and flu season, the company said.

In addition to the Last Names Giveaway, the Simple Acts of Relief program also includes an instant win game, a sweepstakes that includes a grand prize of $100,000, and a mobile tour, where Robitussin will visit cities across the nation to provide cold sufferers with a "simple act of relief," such as a refreshment, a warm scarf or a coupon towards Robitussin.

For more information, visit SimpleActsofRelief.com.


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Winn-Dixie announces intradermal flu vaccine availability at pharmacies

BY Allison Cerra

JACKSONVILLE, Fla. — Winn-Dixie has expanded its flu shot options by offering the Fluzone Intradermal vaccination at its in-store pharmacies.

The intradermal vaccine is available for guests at the discounted rate of $29.99 when purchased using their Winn-Dixie customer reward card, the supermarket chain said. The vaccination, which is administered just below the skin with a microneedle that is 90% smaller than regular needles, is approved for customers ages 18 to 64 years. Winn-Dixie said the flu shot option is in addition to the regular flu shot, approved for people ages 3 years and older, and a high-dose flu shot, approved and recommended for people ages 65 years and older, that it offers to customers.

Certain age restrictions may apply in some states regarding pharmacist administration of vaccinations, Winn-Dixie noted.

“We are constantly looking for ways to meet and exceed our guests’ expectations and offering a variety of administrations for the seasonal flu vaccine is just another way for us to properly serve our guests,” Winn-Dixie VP pharmacy John Fegan said. “Our guests’ health and wellness is our primary concern, and being at the forefront with new innovations helps us to provide these services to our neighborhoods.”


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