How to reduce healthcare spending through MTM

The ability to maintain good health is priceless, but saving billions in healthcare spending while improving patients’ lives is within reach even as medication costs skyrocket.

One metric that illustrates the importance we place on our welfare is healthcare spending, which in 2013 totaled $2.9 trillion or $9,255 per person. A large chunk of what insurers spend can be saved by improving medication adherence through medication therapy management done right.

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Marc O'ConnorMedication nonadherence is a serious problem, with the World Health Organization noting that the average nonadherence rate is 50% for those with chronic illnesses. Chronically ill patients,which account for 20% of the population, account for 80% of U.S. healthcare spending.

According to a meta-analysis published in the Annals of Internal Medicine, Americans are failing to comply with medication prescriptions for a variety of reasons,and it's costing  anywhere between $100 billion to $289 billion a year. According to a 2013 IMS Health study, more than $105 billion in avoidable healthcare expenditures is directly attributed to medication nonadherence.

As it relates to pharmacotherapy, payers need to ensure stellar adherence to high-cost therapies among their patients. 

Read: Multidrug therapy for Hepatitis C can reduce treatment timelines

With the advancement of technology, existence of robust data sets and unparalleled access to medical knowledge, pharmaceutical manufacturers are now able to create curative therapies. The value of a $94,500 course of Gilead’s Harvoni (list price before manufacturer co-pay assistance) that cures hepatitis C versus a $500,000 liver transplant is easy to understand.

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