The $100 Billion Problem with Medication Adherence

Medication adherence, or the lack thereof, is a costly problem within the U.S. healthcare system. When patients fail to take their medicine according to prescribed dosage, time, frequency and direction, adherence declines and doctor and emergency room visits increase. This can result in up to 69 percent of medication-related hospital visits at a cost of approximately $100 billion a year.

The statistics speak for themselves: only seven in 10 consumers get their prescriptions filled, while just three out of 10 have their medications refilled. Although there may be other contributing factors as to why this problem exists, the bigger problem is that patients are not getting the information they need, or reminders of how, to adhere to prescriptions properly.

As a pharmacy benefit manager, your organization has the ability to help these individuals stay healthy through proper medication adherence. Here are two solutions you can implement to help alleviate this costly problem:

• Messaging: During the peak of the problem, consumers were confused as to what, where and how they needed to adhere to their medications. High deductibles for pharmacy benefits helped increase this confusion, but if messaging regarding in-network availability, coverage and medications were targeted properly, the confusion could very well disappear. Patients today prefer easy-to-digest information as well as reminders for their prescriptions, all of which should be delivered according to consumer preferences. Mobile health solutions, such as text messages that simply reminding patients to take their medication, can go a long way to help solve the problem with all age groups. Seniors tend to appreciate their smartphones more than younger demographics, citing them as “freeing.” This opens the door to new and effective messaging tactics for older individuals who rely on medication for their wellbeing.
• Cost: Prescription pricing has always been a key deterrent of medication adherence, with many patients not following through with refills due to cost. By providing consumers with access to drug pricing specific to their health coverage, you can help them save money, find generics alternatives, and improve overall morale to ultimately improve medication adherence. Should this information be accessible through mobile devices, like downloadable apps, an even wider range of patients can benefit as well.

Medication non-adherence doesn’t have to be an issue, but unfortunately, it is capable of making a huge impact on the entire healthcare industry. PBMs and health plan providers can help reduce the negative effects by offering patients better access to information and reaching them through their preferred methods. To find out more about mHealth solutions for medication adherence, contact RxEOB today.