According to a recent Commonwealth Fund report, Americans pay more for brand-name drugs than residents of most other countries, including Japan, the United Kingdom, Australia, Germany, France, Canada and Switzerland. From January 2022 to January 2023, the prices of over 4,200 drug products rose, with nearly half exceeding the rate of inflation and an average price increase of $590 per drug product. The rising cost of prescription drug prices in the United States has created challenges for taxpayers, healthcare payers, employers and most importantly patients.

Nearly one in four Americans taking prescription medications say it’s difficult to afford them. The financial burden has led many to take cost-saving measures such as skipping or delaying filling a prescription, missing or reducing doses, or using someone else’s medication, drawing attention to the critical issue of medication adherence.

What is medication adherence?

Medication adherence is the act or extent of conforming to a provider recommendation/prescription based on timing, dosage and frequency of medication use.

 Why is medication adherence important?

Medication adherence is a primary determinant of treatment success and one of the most important things an individual can do for their health. Failing to follow prescribed medication regimens can have serious consequences for the nearly 67% of Americans who are non-adherent.

• Reduced effectiveness—Medications may not work as intended, leading to inadequate management of health conditions. Non-adherence can account for up to 50% of treatment failures.
• Worsening symptoms—Failure to adhere to prescribed treatments may result in the exacerbation of symptoms or disease progression. According to the CDC, nearly 50% of adults suffer from chronic diseases, such as diabetes and hypertension. Nearly half of these do not adhere to prescribed medication regimens. This failure to adhere is believed to contribute to a minimum of 100,000 preventable deaths and $100 billion in preventable medical costs annually.
• Complications and side effects—Skipping doses or not following medication instructions may contribute to adverse effects or complications. Appropriate medication treatment has the potential to prevent approximately 89,000 premature deaths annually among hypertensive patients.
• Lack of productivity—For chronic conditions, non-adherence may result in a decline in productivity due to increased sick days or disability. If a group of 1,000 employees with diabetes collectively improves their treatment adherence by 10 percent, it could reduce short-term disability and lost work time up to 441 workdays, resulting in potential employer savings of around $94,000.
• Decreased quality of life—Non-adherence may diminish overall wellbeing and hinder individuals’ ability to maintain a satisfactory quality of life. The risk of death due to medication non-adherence is approximately ten times higher than the risk of homicide, escalating to around 30 times for individuals over 50. Morbidity and mortality associated with poor medication adherence costs $528.4 billion annually.
• Risk of hospitalization—Lack of adherence increases the likelihood of severe health events, potentially requiring hospitalization. Twenty percent of Medicare patients are readmitted to the hospital within 30 days. Fifty percent of these are considered non-adherent. Non-adherence can be attributed to up to 25% of hospitalizations in the United States annually.
• Impact on public health—Non-adherence is recognized as a significant public health issue. It leads to poor health outcomes and increased healthcare costs, and can have broad implications for public health, especially when it comes to the management of chronic conditions. As many as 59% of individuals with mental illness inconsistently or do no take their medication. This behavior contributes to broader societal problems, including increased rates of suicide, and increased rates of unemployment and homelessness.
• Increased healthcare costs—Non-adherence can lead to more frequent doctor visits, hospitalizations, and additional medical expenses. Addressing medication adherence has the potential to reduce annual healthcare costs by $100 to $300 billion.

Research has repeatedly found that the primary factor impacting medication adherence is cost. In light of this challenge, innovative programs like Magellan Healthcare’s inforMED Pharmacy Program offer a promising solution by ensuring behavioral health and other medications are prescribed and managed effectively. Visit here to learn more about inforMED and how it reduces pharmacy spend with a 2:1 ROI and gaps in care by up to 40%.

Sources:

• 15 Frightening Stats on Medication Adherence (Plus Infographic) (pillsy.com)
• Changes in the List Prices of Prescription Drugs, 2017-2023 | ASPE (hhs.gov)
• Medication Adherence: The Elephant in the Room (uspharmacist.com)
• Medication Adherence and Compliance: Recipe for Improving Patient Outcomes – PMC (nih.gov)
• Medication Adherence Measures: An Overview – PMC (nih.gov)
• International Price Comparison of Drugs Medicare Is Negotiating (commonwealthfund.org)
• Products – Data Briefs – Number 470 – June 2023 (cdc.gov)
• The Unmet Challenge of Medication Nonadherence – PMC (nih.gov)
• The Workplace Costs of Not Taking Your Medication | The Pursuit | University of Michigan School of Public Health | Chronic Disease | Statistics | Health Informatics | Pharmaceuticals (umich.edu)

Taking your medications exactly as prescribed (improving medication adherence) is one of the most important things you can do to enhance your health and prevent medical complications.

For many Americans, medication adherence can be difficult to maintain. There are a number of barriers that we face every day, from social determinants of health (like medication cost, the ability to get your medication, etc.) to simply remembering when and how often to take your prescription.

As part of your pharmacy care team, we are dedicated to helping you manage your medications so you can live a healthy life. Here are 5 tips for improving medication adherence:

1. Set a reminder: Forgetfulness is the leading cause of non-adherence. Set an alarm on your phone or use a weekly pill organizer to remember when to take your medication, and include a note on how to take your medication (on an empty stomach, with water, with food, etc.)
2. Understand your medication: Understand how your medication works and why it is important to take it as prescribed. Ask your physician or pharmacist follow-up questions about anything you don’t understand. The more you know, the more likely you are to stay on track.
3. Know what happens if you miss a dose: What happens when you don’t take your medication as prescribed? Sometimes it sets back your treatment or can cause adverse effects or symptoms. If you do miss a dose, reach out to your pharmacist! Follow up with them as soon as you remember to minimize negative effects and get back on track.
4. Know your options: We understand that medication can be expensive, but there are things you can do to help reduce the cost to you. Call your health plan to make sure you are using a preferred pharmacy or to find out what medication alternatives are covered and available. If applicable, talk to your pharmacist about filling a 90-day supply, sometimes this can cost less than a monthly refill.
5. Plan ahead for refills:Get into the habit of checking your bottle for the number of remaining refills. Most pharmacies will call your doctor for you when refills run out, but it’s always a good idea for you to know when your prescription is coming to an end.

The Centers for Medicare and Medicaid Services (CMS) Star Rating program is designed to measure and improve the overall performance and quality of care health plans provide to

Medicare beneficiaries.  Due to changes in individual measure specifications, benchmarks, and inclusion into the overall calculation, this quality rating system continues to evolve – which can make it challenging to achieve and maintain 5-Star performance.

Listen to our latest webinar to learn about clinical strategies that can help you stay ahead of the curve for various Part C and D clinical measures such as rheumatoid arthritis management, osteoporosis management, statins in diabetes, and medication adherence for diabetes, hypertension (renin-angiotensin system antagonists), and cholesterol (statins).