Medication adherence is one of the costliest healthcare issues to address today. Given that approximately half of all American adults have one or more chronic health conditions medication adherence is vital for not only improving health outcomes for millions of Americans, but also lowering healthcare spending and achieving optimal business results for payers and pharmaceutical companies alike.
Those who do take their medications only end up taking about half of the prescribed dose. Whether intentional or unintentional, non-adherence like this creates an extra $290 billion spent annually on avoidable medical costs. For pharmaceutical companies, medication non-adherence presents an even larger financial impact: $637 billion annually. Increasing adherence rates would translate to fewer unnecessary hospitalizations and deaths and reduce healthcare spending overall. For the pharmaceutical industry, even a 10 percent increase in adherence rates would create a $41 billion revenue opportunity in the United States.
Poor medication adherence can be caused by several factors. Patients may dislike the idea of taking medication or feel they don’t need it. Patients may be overwhelmed or confused by the prescription. Patients may be unable to afford their prescriptions. Estimates have shown that up to 80 percent of nonadherence is intentional, making patient perception a critical piece of the puzzle. Educating the patient in partnership with healthcare professionals must be a priority for payers and pharmaceutical companies looking to increase adherence rates. The community pharmacist is the best-positioned healthcare professional to drive medication adherence rates.
Pharmacists are trusted. Simply put, patients trust their pharmacists. A recent Gallup poll named pharmacists ahead of medical doctors for honesty and ethical standards, making pharmacists second to nurses as the most trusted healthcare professional.
Community pharmacists are positioned to not only change perception of medications, but also to guide patients through a confusing healthcare landscape, making sure patients understand their options and have the best plan in place to access the medications they need at the best price. Pharmacists can make sure the patient is not impacted by yearly changes in formularies and work with a prescriber to suggest alternative medications that work with a patient’s plan. This is especially pertinent among Medicare patients who can often select plans not aligned to their needs, or fail to adapt to new plans when existing medications are no longer covered or become more expensive.
Pharmacists are accessible. Patients see their pharmacists more regularly. In one study of high risk Medicaid patients, patients visited their primary care physician an average of 4 times per year, had 9 outpatient or specialist visits per year, and visited their community pharmacy over 35 times each year. No healthcare professional has more access to patients than a pharmacist. Given the wide-ranging issues associated with medication non-adherence, pharmacists are able to tailor their care for a patient’s specific needs, providing accountability and support. Proximity also creates opportunity to follow up. 94 percent of Americans live within five miles of a community pharmacy.
Educating patients. One study found that two of the top six predictors of medication adherence include how important a patient feels it is to take their medication exactly as prescribed, and how well-informed they feel about their health. Many community pharmacists are actively educating their patients every day, taking advantage of the latest technologies to engage and counsel patients on their condition.
Studies have shown the correlation between patient education conducted by community pharmacists and cost savings. Let’s take diabetes for example. One study among 12 community pharmacies in Asheville, N.C. took on a patient education initiative to improve health outcomes and medical costs among diabetes patients. The program utilized follow-ups and consultations with community pharmacists, goal setting, health monitoring and collaborative drug therapy management with physicians. The results: over 50 percent of patients demonstrated improvements in their diabetes symptoms. Total medical costs shifted from inpatient and outpatient physician services to prescriptions (increasing at each follow up), and decreased by $1,200 per patient per year.
We at PrescribeWellness have been working with community pharmacists to streamline their ability to interact with and reach more patients, reinforce adherence and improve loyalty. In 2016, our pharmacy clients moved over 100,000 diabetic patients from non-adherent to adherent using our technology platform, representing a reduced medical spending of $4.4 million.
The Institute for Alternative Futures forecasts that by 2030, nearly 55 million Americans will have diabetes, increasing medical and societal costs related to diabetes by 53 percent to $622 billion annually. Today, diabetes treatment non-adherence costs $4 billion. Think about the impact that could be had if the healthcare community banded together to educate patients more effectively on prevention and medication adherence.
One community pharmacist leading the charge in this respect is Dr. Jonathan Marquess. Dr. Marquess and his wife own several community pharmacies in Georgia and he is currently serving on the American Pharmacists Association Board of Trustees. He frequently conducts diabetes education classes at his pharmacies, highlighting issues of diabetes prevention, management, and medication adherence.
PrescribeWellness recently partnered with him to host a Facebook Live event on the basics of diabetes management. Dr. Marquess addressed tips for managing health for those with diabetes along with answering questions from event attendees online and at the pharmacy. He represents thousands of community pharmacists across the nation working to help patients navigate their health risks and conditions each day.
- New England Healthcare Institute, Thinking Outside the Pillbox: A System-wide Approach to Improving Patient Medication Adherence for Chronic Disease. August 12, 2009.