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High price of drugs is biggest issue in prescription adherence, physicians say

Only 5 percent of physicians always track whether their patients are taking their drugs, survey says.

Susan Morse, Managing Editor

A new drug cost survey reveals that over 90 percent of physicians believe they have a role to play in discussing healthcare costs with patients.

Unfilled prescriptions remain a problem, with 73 percent of physicians taking the patient's responsibility for cost into account in making a prescribing decision, according to the survey released by OptimizeRx. Almost as many physicians, 70 percent, said they believe the high cost of prescribed medications leads to unfilled prescriptions.

While doctors believe they understand the reasons for patients not filling prescriptions, few track when patients haven't filled their scripts. Only 5 percent of physicians said they "always" track an unfilled prescription and 18 percent said they "usually" do. This means that three-quarters of physicians are not tracking unfilled prescriptions.

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High drug prices have come under legislative scrutiny in numerous hearings, including one in February which the heads of seven Big Pharma companies were questioned by the Senate Committee on Finance.

The Senate Finance Committee is scheduled to hold another hearing with pharmacy benefit managers on April 3, questioning their role in prescription drug prices.

The companies invited to attend include Cigna, CVS Caremark and CVS Health, Humana, OptumRx and Prime Therapeutics.

Providers bear the cost when consumers don't fill their prescriptions because of the increased risk of these patients coming to the ER or of being readmitted to the hospital when their conditions worsen.

Nearly 30 percent of Americans don't take their prescribed medications because of high drug prices, according to the Kaiser Family Foundation health tracking poll released in February.

This affects numerous Americans, as six in ten use prescription drugs, the Kaiser poll found. Among senior citizens, nine in 10 use prescription drugs and more than half take four or more.

The data on prescription adherence is available to pharmacies and insurers through claims and is increasingly of interest to providers who are tracking how the social determinants, such as income, play a role in health and value-based care. 

Lack of medication adherence costs the U.S. health system as much as $528 billion in the context of possible consequences, illnesses, and deaths that result from non-adherence, according to the survey by OptimizeRx, which is in the business of offering a cloud-based solution in support of patient adherence to medications. The digital health company connects pharmaceutical companies to patients and providers. 

The survey was released in partnership with Jane Sarasohn-Kahn, a health economist and advisor from consultant Think-Health. It was done through OptimizeMDs, a multi-specialty physician panel created by OptimizeRx. The survey was conducted between January 9 and 14 and includes responses from 642 physicians across a variety of specialties, practices and hospitals.

The initial results were released at the HIMSS 2019 global  conference in February.

The vast majority of patients raise the issue of prescription prices with their doctors and 86 percent of physicians are comfortable discussing these and other healthcare costs, according to the survey.

Other factors physicians cited for unfilled prescriptions include intolerable or unpleasant side effects (45 percent); a patient's desire not to take pills (34 percent) and patients already taking too many pills (31 percent).


"Patients are at-risk of contributing to this public health challenge when they avoid filling prescriptions," Sarasohn-Kahn said. "There are strategies that can help to risk-manage this in order to lower care costs and improve people's outcomes. We need to address this through an ecosystem-wide, holistic lens."

Miriam Paramore, president of OptimizeRx: "Shared decision-making between patients and prescribers will be more important than ever, and the cost-conversations and discussions around access will be central in the patient-prescriber relationship."

Twitter: @SusanJMorse
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