Medication adherence leads to lower healthcare costs
Patients with one or more of four chronic diseases who take their medications as prescribed may save the healthcare system as much as $7,800 per patient annually, according to the findings of a CVS Caremark study analyzing annual pharmacy and medical costs over a three-year period.
The study findings revealed robust reductions in emergency department visits and in-patient hospital days from medication adherence. By avoiding those costly events, there were substantial savings in overall healthcare costs. The study, “Medication Adherence Leads to Lower Health Care Use and Costs Despite Increased Drug Spending,” was released in the January 2011 issue of Health Affairs.
Company researchers analyzed pharmacy and medical claims data of 135,000 patients with congestive heart failure, diabetes, hypertension and dyslipidemia to determine the direct effect of adherence on costs, according to Troyen Brennan, EVP and chief medical officer of CVS Caremark and a study author.
Among the disease-specific findings are:
People with congestive heart failure spent $39,076 on average annually and had an average of 11.9 days in the hospital. Those with congestive heart failure were older, averaging 77 years of age;
Diabetes costs per patient on average were $17,955 annually, and these patients had an average of 4.26 days in the hospital;
Hypertension patients spent $14,813 on average annually and had 3.29 days on average in the hospital; and
The annual spend for a person being treated for dyslipidemia was $12,688 on average. Hospital stays for these patients were 2.24 days on average.
Pharmacy costs for the patients ranged from $2,867 to $3,780 per year.
Pharmacists, nurses prove most effective in promoting Rx adherence
A CVS Caremark-sponsored study looking at in-person, electronic, telephone, fax and mail communications that counsel patients to stay on their medications found that pharmacists in a retail setting are the most influential healthcare “voices” in promoting medication adherence.
The research, based on a review of more than 40 years of studies published in medical journals, found that pharmacists engaged in face-to-face discussions with patients in a store were twice as effective in boosting adherence rates as programs in which pharmacists talk with patients on the telephone.
Researchers also found that nurses talking with patients as they are discharged from a hospital are the second most influential voice in getting patients to take their medications as prescribed.
Patients with complex therapies struggle to stay adherent
Patients with chronic heart disease are likely to have several doctors and take nearly a dozen medications that are filled in at least two different pharmacies, resulting in many patients struggling to keep their medications straight, according to a study conducted by researchers from Harvard Medical School, Brigham and Women’s Hospital, and CVS Caremark.
Among the potential solutions: Create a “pharmacy home” to coordinate pharmacy care from a single point of contact. Researchers also said there is a need to synchronize medication regimens for patients because “those who make numerous trips to the pharmacy to pick up their medications, or fill prescriptions at different pharmacies, may have difficulty taking their medications as prescribed.”
Researchers found that during a three-month period, “10% of patients filled prescriptions for 23 or more medications … and 11 or more different drug classes, had prescriptions written by four or more prescribers, filled these prescriptions at two pharmacies and made 11 or more visits to those pharmacies.”