Taking the Right Meds at the Right Time: Medication Adherence, Health Outcomes and Costs

November 16, 2015

Evidence shows that medication adherence—the extent to which a person takes medications as prescribed by their health care providers—is associated with improved health care outcomes for many costly chronic conditions, including heart disease, diabetes, and asthma. However, only 50% percent of Americans are estimated to take their medications as prescribed, and non-adherence is estimated to result in added direct and indirect costs to the healthcare system of over $300 billion per year. The challenges and policy questions surrounding medication adherence affect Medicare, Medicaid, and the private sector – and offer a window into broader questions surrounding the ability of our health care system to coordinate care, particularly for people with multiple chronic conditions. In this briefing, top experts from the public and private sectors explored key policy, practical, and research questions surrounding medication adherence and management of medications.

If you were unable to attend the briefing, here are some key takeaways: 
Tom Hubbard, Vice President of Policy Research, Network for Excellence in Healthcare Innovation (NEHI)
HIGHER COSTS FOR NON-ADHERERS. Non-adherence leads to poorer outcomes, especially for those with chronic disease, and increased costs, Tom Hubbard said. He cited a University of Maryland study featured in Health Affairs, conducted on diabetic Medicare beneficiaries enrolled in Part D, which found that monthly spending for Medicare Part A and B was much higher for non-adherers compared to those who consistently took their medication.

Jonathan Blum, Executive Vice President for Medical Affairs, CareFirst BlueCross BlueShield
ADHERENCE PROGRAMS. Pharmacy spending is on the rise and constitutes a larger percentage of the medical dollar, Jonathan Blum stated. CareFirst has implemented many programs that focus on lowering the cost of drugs and encouraging medication adherence. One of these, the Pharmacy Coordination Program, provides a nurse case manager to Medicare beneficiaries in order to answer questions about side effects, highlight the importance of adherence and coordinate with primary care physicians, he continued.

Raja Zeitany, Pharm. D., Chief Pharmacy Officer, Providence Health & Services
ADHERENCE LEADS TO IMPROVEMENT IN MORTALITY. The lack of adherence to a medication regimen makes it very difficult to manage a population’s health and is the 4th leading cause of death in the United States, Raja Zeitany stated. In a study that looked at medication adherence for cholesterol management, there was a 40 percent improvement in mortality when medications were used appropriately, he added.

LARGE ROI FOR MEDICATION ADHERENCE PROGRAMS. The benefit to cost ratio for medication adherence programs for congestive heart failure is 8.4 to 1. In other words, for every dollar spent on medication adherence programs, there is an $8.40 return on investment, Raja Zeitany said.

Marie Brown, M.D., F.A.C.P., Associate Professor of Medicine, Rush University Medical Center, and Governor of the Northern Illinois Chapter of the American College of Physicians
REASONS FOR NON-ADHERENCE. Over 70 percent of non-adherence is due to reasons other than forgetfulness and is often times intentional, Marie Brown stated. These reasons can include: cost, confusion, or personal beliefs. Providers must build trust with their patients without admonishing them to encourage honesty about their medication adherence, she continued.

Sarah Dash of the Alliance for Health Reform and William Shrank of CVS Health co-moderated the panel discussion.
PERSONALIZED INTERVENTIONS. Fifty percent of patients do not take their medication as prescribed, which often leads to morbidity, mortality and higher costs, William Shrank stated. Responses must be personalized to address the variety of reasons non-adherence occurs. CVS is implementing interventions that range from synchronizing prescription refills, creating better benefit design to reduce the cost of medications, digital support to remind patients when to take their prescriptions and encouraging pharmacists to build relationships with patients, he added.

Follow the Briefing on Twitter: #RxAdherence

Contact: Sarah Dash sarahdash@allhealth.org 202-789-2300

The event was organized by the nonpartisan Alliance for Health Reform with support from CVS Health.


Full Transcript (Adobe Acrobat PDF)

Speaker Presentations

Tom Hubbard Presentation (Adobe Acrobat PDF)
Marie Brown Presentation (Adobe Acrobat PDF)
Jonathan Blum Presentation (Adobe Acrobat PDF)
Raja Zeitany Presentation (Adobe Acrobat PDF)

Event Details

Agenda (Adobe Acrobat PDF)
Speaker Biographies (Adobe Acrobat PDF)

Event Resources