Pharmacist expertise could save $20 billion

July 15, 2013

Pharmacist counseling is cost-effective and can contribute to improved adherence.

By improving medication adherence and generic drug use, the United States healthcare system could save $20 billion in medical costs, according to CVS Caremark’s 2013 State of the States: Medication Adherence Report.

The second-annual report projects potential cost-savings for each state by examining medication adherence rates and the use of generic drugs for diabetes, hypertension (high blood pressure), dyslipidemia (high cholesterol) and depression. Based on state member characteristics, potential cost-savings among states range from $19 million to $2.1 billion.

The report also examines three market segments: health plans, employer-sponsored plans and Medicare Part D prescription drug plans. An interactive hub allows viewers to filter data based on market segment, health condition and adherence measure to gain insight into a specific state or draw comparisons among them. 

The report also found that $13.4 billion could be saved if patients switched from expensive brands to generics. Another $6.5 billion could be saved if patients picked up their prescriptions 80% of the time.  

While the report focuses on state-specific data, results reflected some important trends in medication adherence nationwide.

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

The Midwest had the lowest adherence rates for health plan members with diabetes and depression, while the South had the lowest rates for patients with any condition in employer-sponsored plans and Medicare Part D.

Medication nonadherence in the United States already accounts for up to $290 billion annually in excess healthcare costs, according to the New England Healthcare Institute. Research shows that interventions such as pharmacist counseling are cost-effective and contribute to improved adherence, showing that pharmacists and other healthcare professionals can help patients effectively manage chronic diseases.

The CVS Caremark Pharmacy Advisor counseling program has been shown to increase adherence rates up to 3.9% and return $3 in savings for every $1 on counseling. In a multi-year collaboration with Brigham and Women’s Hospital, CVS Caremark has worked to research pharmacy claims data in order to better understand what influences medication adherence.