Increased Medication Adherence Reduces Health Care Costs

Aimee Simone, Assistant Editor

Increased medication adherence not only improves patient outcomes but can also lower the overall cost of care in the United States, according to a review released this month by Avalere Health and funded by the National Association of Chain Drug Stores The review, titled “The Role of Medication Adherence in the U.S. Healthcare System,” suggests that increased medication adherence is one way to address rising health care costs as the population continues to age. Through an examination of published research on the relationship between medication adherence and health outcomes and health care system spending, the authors present data on the cost-effectiveness of medication adherence, the most common barriers to adherence, and how adherence can be improved through intervention programs.Results from a number of studies included in the review indicate that increased medication adherence improves health outcomes in patients while reducing their use of health care services, such as hospitals, which leads to a lower overall cost of care. In contrast, non-adherence to medication has been found to increase overall health care spending.For example, a 2009 study of Medicaid patients with congestive heart failure found that patients who adhered to medications had fewer hospitalizations, fewer visits to the emergency department, and overall health care costs that were 23% lower than those of non-adherent patients.In a 2005 study, researchers estimated that 33% to 69% of all medication-related hospitalizations in the United States were caused by non-adherence. Another 2005 study found that total annual health care spending for diabetes patients with the lowest levels of medication adherence was almost twice that of diabetes patients with high levels of adherence. This study also found that although patients who were adherent had higher drug costs, their overall cost of care was lower. Additional studies have found similar results, reporting that overall medical cost savings outweigh increased costs from more frequent prescription drug use.Although the financial and health benefits of medication adherence are substantial, the review authors note that high levels of adherence can be difficult to achieve due to barriers faced by patients. Among these barriers are rising copayment burdens, which have been linked with lower adherence rates and increased hospital use in several studies.Limited access to drugs is another contributor to medication non-adherence. For example, a retrospective study of hypertension patients found that participants were 39% more likely to stop taking their medications a year after a preferred drug list was implemented for their state’s Medicaid program. Patients with complex treatments are also more likely to be non-adherent, according to multiple studies.Despite these barriers, intervention programs led by pharmacists have been shown to improve adherence among patients. In a study conducted in 2012, diabetes patients who had either face-to-face meetings with pharmacists or phone contact with mail-order pharmacists had higher adherence levels than patients who had no interaction with pharmacists. Other studies have indicated the importance of medication therapy management (MTM) and comprehensive medication reviews (CMRs) on patients’ medication adherence levels. The results of a recent study of Medicare patients diagnosed with chronic heart failure or chronic obstructive pulmonary disease found that patients who received MTM services were more likely to be adherent than those who did not. Patients who also received a CMR had the greatest improvements in medication adherence.The authors of the review conclude that health care professionals and policymakers alike should focus on increased patient interaction and education to increase medication adherence, which will in turn improve health outcomes and decrease overall health care costs.