If only someone would invent an app that made people adhere to their prescription drug regimens, billions each year could be saved. But until that time, human nature being what it is, nearly half of users of drugs designed to keep them healthy will continue to flaunt the schedule for taking their little pills.
That's what population health company Healthentic found when it reviewed nearly 100,000 patient records in its database. The cost to society of medication non-adherence it came up with is certain to raise eyebrows: between $100 billion and $289 billion every year in direct costs. And, employers take note: Healthentic estimates that "losses in productivity due to health related factors could multiply that by 2.3 times."
Healthentic studied three major disease conditions: diabetes, high blood pressure and high cholesterol.
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The study disclosed that about 50 percent of patients don't take their medication as directed. Meantime, those who followed the directives at least 80 percent of the time were considered to be adherent — a fairly low bar given that prescriptions are written to be followed 100 percent of the time.
Looking at the 50-percent-or-less population in the data base, Healthentic listed the following projected implications over a full year for this sample group:
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128 avoidable hospitalizations for diabetes, totaling over $2.1 million in avoidable costs;
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243 avoidable hospitalizations for high blood pressure, totaling over $4 million in avoidable costs;
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150 avoidable hospitalizations for high cholesterol, totaling almost $2.5 million in avoidable costs.
"Compared to the adherent patients who took their medication 80 percent of the time or more, the non-adherent patients who took medication 40-59 percent of the time had significantly higher rates of hospitalization," Healthentic said. It released the following stats:
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Among diabetics the rate was 134 percent higher;
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For those with high blood pressure the rate was 59 percent higher;
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And for patients with high cholesterol the rate was 39 percent higher.
Healthentic then broke out the implications by disease. Here's what it reported for those being treated for diabetes: "Among the 3,314 patients with diabetes in our database, we found that nearly half were non-adherent. Those 1,605 non-adherent diabetics had 295 hospital admissions altogether. If we could have magically gone back in time and made those patients adherent, those patients would have had 167 hospitalizations instead. With an average hospital bill of $16,529, that is 128 fewer hospitalizations that would have saved $2.1 million in hospital costs among the patients in our database."
Similar results were found for high blood pressure and cholesterol. It was these figures that were the basis for its projections of $100 billion to $289 billion in unnecessary medical bills annually.
"Depending on how often they take their medications, non-adherent patients are 63 to 134 percent more likely to be hospitalized for high cholesterol, high blood pressure and diabetes," the study concluded.
Employers can influence this general lack of adherence, Healthentic said, by taking the following steps:
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Identifying health plans with lower out-of-pocket costs for prescription medications
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Looking for health care systems with a patient-centered, team approach to care
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Targeting outreach to non-adherent employees with programs that have shown success for their specific conditions
"Too many employers are focusing their workplace health efforts on things that don't make an impact to health or costs," said Al Lewis, founder and president of Disease Management Purchasing Consortium. "Managing specific people and conditions in a population, using tools like medication adherence, is one of the most effective ways to avoid expensive hospitalization and keep people healthy — if you target the right people."
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Dan Cook
Dan Cook is a journalist and communications consultant based in Portland, OR. During his journalism career he has been a reporter and editor for a variety of media companies, including American Lawyer Media, BusinessWeek, Newhouse Newspapers, Knight-Ridder, Time Inc., and Reuters. He specializes in health care and insurance related coverage for BenefitsPRO.
