Does It Pay to Stay Adherent?

MedicationsSometimes a patient’s ability to remain adherent to drug therapies is based on their finances. While reducing prescription intake can seem like a good idea in the short-term (i.e. reduce monthly Rx expenses), in the long-term this approach can actually increase overall healthcare expenses.

In 2014, the Joint Health Management Board is taking a deeper look at medication adherence for 5 key categories; 1) Cholesterol, 2) Hypertension, 3) Diabetes, 4) Asthma, and 5) Heart Disease. This month, the group partnered with its Benefits Integrator, Claremont Partners, to analyze the effect of medication adherence on annual costs for members on hypertension and/or cholesterol drug therapies. Not surprisingly the results are consistent with research performed by the New England Journal of Medicine, which stated:

Poor adherence to treatment regimens has long been recognized as a substantial roadblock to achieving better outcomes for patients. Data show that as many as half of all patients do not adhere faithfully to their prescription-medication regimens — and the result is more than $100 billion spent each year on avoidable hospitalizations.The New England Journal of Medicine

Let’s take a closer look at our own research, which analyzed medication adherence for a one-year period from Nov 1, 2012 to Oct 31, 2013. For the purposes of our research, medication adherence is defined as members being at least 80% adherent to their respective drug therapies.

Annual Rx Costs

In short-term, it may seem that non-adherence reduces the burden on members’ wallet. For example, members on hypertension and/or cholesterol drug therapies reduced their annual prescription costs by $106 and reduced the plan’s annual prescription costs by $735. Yet, that’s not the full story…


Annual Medical Costs

Though non-adherence reduced up-front prescription costs, the annual costs for medical care were substantially higher for non-adherent members. Annual member costs were $211 higher for non-adherent members and overall plan costs were 57% higher for non-adherent members.


Annual Total Costs

In the case of medication adherence for hypertension and cholesterol drug therapies, it clearly pays to remain adherent. Adherent members saved $105 in combined Rx and medical costs for the year and the plan costs were 21% lower.


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