Experts say improved medication adherence could save $300B a year

A group of healthcare and consumer organizations and companies has released five policy recommendations designed to promote better medication adherence, with potential savings of as much as $300 billion a year.

The group, which includes 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, says improved adherence will improve patient outcomes and save billions in healthcare costs.

Although some of the recommendations have been discussed during the ongoing healthcare reform debate and in fact have been reflected in some of the proposals under consideration, the group said the recommendations are being released now with an eye toward an ongoing and consistent commitment to improving healthcare and health outcomes.

The group cites a 2005 study published in the New England Journal of Medicine, in which an estimated one-third to one-half of all patients in the United States reportedly do not take their medications as prescribed.

Recent research, including work by New England Healthcare Institute and a 2004 study published in Medical Care, suggested that costs resulting from non-adherence might be as high as $300 billion annually.

"Not only is poor medication adherence costly, but it also can be dangerous," said Sally Greenberg, executive director of the National Consumers League. "Because patients don't take their medications for a variety of reasons, including cost such as co-pays and deductibles, side effects, misconceptions or fears and trouble with administration, we need to employ a multitude of strategies to improve adherence. Our efforts are focused on identifying key opportunities to improve the healthcare system and reduce barriers that keep patients from getting the best benefit from their medicines."

The five recommendations are:

  1. Quality Improvement – National quality improvement strategies should explicitly recognize medication adherence and appropriate medication use as critical components to improve healthcare quality and clinical outcomes.
  2. Care Coordination – Proposals aimed at improving care coordination must recognize the important role that medications play in treating and managing illnesses.
  3. Health IT – Health IT must improve the flow of timely and complete information between patients and providers, and enable providers and payers to identify and address gaps in patients' medication use.
  4. Patient/Provider Education and Engagement – Strategies to improve medication adherence must fully engage patients, and patient-centered care must involve strategies to help them better understand their conditions and treatments. These efforts also must support providers in effectively communicating the importance of following treatment plans, and in providing medication support services to patients and caregivers.
  5. Health Services Research – There is a need for additional research on medication adherence, including a focus on the effectiveness of a wider range of interventions to improve adherence, as well as an analysis of the diverse factors, behaviors, costs and consequences related to poor adherence.

"Medical adherence is a problem that should unite all providers, elected officials, pharmacists, insurers and pharmaceutical companies," said Jack Lewin, CEO of the American College of Cardiology. "Fifty percent of patients with heart disease are not taking their potentially life-saving medications, but it is our hope that recommendations like these will go a long way toward addressing this serious problem."

The recommendations were developed following a July conference attended by more than 40 medication adherence experts, including providers, patients, payers and academics.

The dialogue was informed by two research presentations by the RAND Corporation, which provided a literature-based framework to help guide the creation of the policy recommendations, and Avalere Health, which described programs to improve medication adherence.