Adherence varies across market segments

August 1, 2013

State-level data shows potential cost savings when patients follow regimens

The U.S. healthcare system could avoid hundreds of millions of dollars in medical costs if medication adherence rates improved, according to a CVS Caremark report.

The 2013 State of the States: Adherence Reportreports potential cost-savings within each state by examining medication adherence rates and the use of generic drugs across four common health conditions: diabetes, hypertension, dyslipidemia (high cholesterol), and depression. The potential cost-savings among the states range from $19 million to $2.1 billion based on state member characteristics. The report looked at health plans, employer-sponsored plans, and Medicare Part D prescription drug plans (PDPs).

“These projections are broken down on a state-by-state basis in the report to call attention to the savings that could be achieved by encouraging people to stay on their medications and to consider generic alternatives when they are available,” Christine Cramer, CVS Caremark spokesperson says.

There are many factors that influence adherence, including demographics and access to pharmacy services, which are also highlighted in the report at the state-level, according to Cramer.

Across all market segments, patients with depression generally had the lowest adherence rates, while patients with hypertension were most adherent. Medicare beneficiaries had the highest adherence rates across the three groups.

“There are costs that are avoided when people stay on medication-reduced frequency in trips to the emergency room and in-patient hospital stays, to name a couple of examples-these add costs to the system,” says Cramer. “Getting patients to take their medications can help people remain healthy and reduce costs.”

Adherence rates fluctuate across populations, regions and markets.

Concrete approaches such as designing new packaging and pill boxes that help simplify medication regimens, better medication education and coordination in post-operative care to help reduce readmissions, and pharmacy-based counseling programs can help.

As one element of its research, CVS Caremark has been working in a multi-year collaboration with Brigham and Women’s Hospital to research pharmacy claims data in order to better understand the factors that influence medication adherence.

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