Caregivers likely to be nonadherent
About half of people who provide care and support to loved ones said they are more likely to be nonadherent to their own personal medication regimen than to neglect providing medications to those they are caring for, according to a study by researchers at Harvard University, Brigham and Women’s Hospital, and CVS Caremark. Given this, there’s a significant opportunity for pharmacists and doctors to identify and work with caregivers to improve medication adherence and chronic disease management.
For the study, published in the Journal of the American Pharmacists Association, the research team conducted an online survey of 2,000 retail pharmacy customers of which 38%, or 762 respondents, described themselves as caregivers. Of that group:
45% said they somewhat or strongly agreed that they are more likely to forget to take their own medications, even though they provide family members with their medicines; and
When comparing caregivers with noncaregivers, caregivers said they are 10% more likely to forget taking their medicines, 11% are likely to stop taking their medications if they feel better and 13% said they are likely to forget to fill their refills.
More than 65 million Americans describe themselves as caregivers, and as the U.S. population ages, that number is expected to grow.
Dispense-as-written Rxs exacerbating healthcare costs
“Dispense-as-written” prescriptions are exacerbating medication nonadherence and costing the U.S. healthcare system up to $7.7 billion annually, according to a study by researchers at Harvard University, Brigham and Women’s Hospital, and CVS Caremark.
Researchers estimated that patients in the study would have saved $1.7 million and health plans would have spent $10.6 million less for the medications if effective generic alternatives had been provided in place of brand-specific medications. Assuming a similar rate of dispense-as-written requests for the more than 3.6 billion prescriptions filled in the United States annually, patient costs could be reduced by $1.2 billion, and overall health system costs could be reduced by $7.7 billion.
Researchers also found that when starting new essential therapy, particularly among chronically ill patients with dispense-as-written prescriptions, patients were 50% to 60% less likely to actually fill the more expensive brand-name prescriptions than they were to fill generics.
The study reviewed 5.6 million prescriptions adjudicated by CVS Caremark for 2 million patients from Jan. 1 to 31, 2009.
Medication adherence leads to lower healthcare costs
Patients with one or more of four chronic diseases who take their medications as prescribed may save the healthcare system as much as $7,800 per patient annually, according to the findings of a CVS Caremark study analyzing annual pharmacy and medical costs over a three-year period.
The study findings revealed robust reductions in emergency department visits and in-patient hospital days from medication adherence. By avoiding those costly events, there were substantial savings in overall healthcare costs. The study, “Medication Adherence Leads to Lower Health Care Use and Costs Despite Increased Drug Spending,” was released in the January 2011 issue of Health Affairs.
Company researchers analyzed pharmacy and medical claims data of 135,000 patients with congestive heart failure, diabetes, hypertension and dyslipidemia to determine the direct effect of adherence on costs, according to Troyen Brennan, EVP and chief medical officer of CVS Caremark and a study author.
Among the disease-specific findings are:
People with congestive heart failure spent $39,076 on average annually and had an average of 11.9 days in the hospital. Those with congestive heart failure were older, averaging 77 years of age;
Diabetes costs per patient on average were $17,955 annually, and these patients had an average of 4.26 days in the hospital;
Hypertension patients spent $14,813 on average annually and had 3.29 days on average in the hospital; and
The annual spend for a person being treated for dyslipidemia was $12,688 on average. Hospital stays for these patients were 2.24 days on average.
Pharmacy costs for the patients ranged from $2,867 to $3,780 per year.