POCP Blog

By Tony Schueth

Addressing medication noncompliance is one of the trends we will be seeing in 2018. To be sure, medication noncompliance is a long-standing issue. We have known for a long time that all prescriptions instruct patients to take a medication as directed, yet millions of Americans fail to follow through. So why the focus now on medication noncompliance?

The answer is simple: now we have reached an inflection point where costs, new care models, value-based purchasing and the availability of technology are converging to meaningfully address the problem. This is the first of two blogs on the medication adherence opportunity. This one focuses on drivers for change. The second will highlight some opportunities and barriers for adoption.

Drivers for change. Several drivers are motivating stakeholders to address medication adherence at this time. They include:

• Scope of the problem. About half of the 3.2 billion annual prescriptions dispensed in the United States are not taken as prescribed, and that number is even lower for patients with chronic conditions.
• Costs to the healthcare system. Researchers estimate that medication nonadherence causes some 125,000 deaths, untold disabilities, as well as 10% to 20% of hospitalizations and nursing home admissions each year. This costs the healthcare system between $100 billion and $289 billion annually.
• Costs of noncompliance for chronic illness. There are significant costs associated with individual chronic diseases, such as diabetes, which are on the rise.  According to ExpressScripts, annual spending on compliant diabetics was at least $500 less than for nonadherent patients, which extrapolates to an estimated $210 million in savings for 2016.
• New care models.Medical care is moving toward a patient-centered, team approach, which  engages patients in their care and can help them understand their disease and why they should take medications as directed. This helps motivate patients to be compliant and stay on therapy. Pharmacists’ roles are expanding to include patient counseling with the objective of improving medication compliance.
• Value-based contracting. New value-based contracting arrangements reimburse providers for lower costs, better outcomes and fewer hospitalizations. As a result, medication adherence is becoming both a quality and outcomes measure in accountable care and performance-based contracting, including the Medicare star ratings program. Moreover, the potential savings resulting from improved medication compliance can incent physicians to take a more active role in identifying and addressing adherence.
• Technology. Technology—principally electronic health records (EHRs) and electronic prescribing (ePrescribing)–are now available to better share patient information and help identify noncompliant patients. For example, formulary and benefit information at the point of care can help physicians prescribe affordable medications covered by the patient’s health plan. Prescription price is important because a significant number of prescriptions are abandoned once patients learn how much they will cost, or patients will halve or skip doses to save money. The RxFill function can indicate whether a patient filled or refilled a given medication, which could indicate compliance. Reports can be run on EHRs to identify potentially noncompliant patients. In addition, there is a wide range of wearable, mobile and other devices to help patients improve medication adherence.

 Look for my next blog on medication adherence. In the meantime, reach out to me (tonys@pocp.com) if you have questions or need additional information.

• Post Categories
• eMedication Management
• Medication Therapy Management