A new study published in The American Journal of Managed Care has there is greater opportunity for cost-savings if medication adherence resources are focused on patients with hypertension, diabetes and high cholesterol.
A preliminary analysis by from the CVS Health Research Institute in fact shows that payers could save approximately $38 to $63 million per 100,000 members by focusing resources on these specific patient populations.
Researchers reviewed de-identified medical and pharmacy claims data of more than 1.2 million patients with at least one of those chronic diseases over a two-year period. The study found that the best strategy was to focus on the patients who are adherent and to keep them that way.
For example, a patient with hypertension who was initially adherent, but became non-adherent, spent an additional $2,663 on medical care. And the researchers found that the number of comorbid conditions directly influenced cost savings when adherence behavior improved: Patients with three or more chronic conditions had up to seven times greater savings than patients with one or two conditions.
"There is extensive evidence supporting the relationship between better adherence, improved health outcomes and reduced healthcare costs, but efforts to improve medication adherence, while effective, can be costly," said Troyen Brennan, MD, chief medical officer of CVS Health, in a statement. "We are now trying to better understand how to maximize healthcare resources to have the greatest impact on adherence and provide the maximum benefit for payers and patients. This research indicates that targeting adherence interventions to patients based upon their adherence history and comorbidities would result in greater cost-savings and a better use of healthcare resources."
CVS Health used predictive analytics to help understand which patients are likely to be non-adherent and, as a result, the most costly. It also is working with clients to target certain member populations who can most benefit from its adherence programs.
"Short-term changes in adherence can have a meaningful and immediate impact on healthcare costs, and this kind of research is important in helping our clients understand the value of medication adherence and where the greatest cost-savings opportunities exist for their member populations when it comes to maintaining medication adherence," said Jonathan Roberts, President of CVS Caremark, in a statement. CVS Caremark is the pharmacy benefits manager of CVS Health.
The New England Health Institute has estimated that patient non-adherence to medication regimens can drive as much as $284 billion in annual costs. Non-adherence to medical advice for dietary, exercise, smoking and alcohol use have been observed to be significantly higher.
In 2009, a group including the American College of Cardiology, GlaxoSmithKline, the National Association of Chain Drug Stores, the National Consumers League and the Pharmaceutical Research and Manufacturers of America said improved adherence will improve patient outcomes and save billions in healthcare costs -- potentially as much as $300 billion per year.