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Patients with complex therapies struggle to stay adherent

BY Antoinette Alexander

Patients with chronic heart disease are likely to have several doctors and take nearly a dozen medications that are filled in at least two different pharmacies, resulting in many patients struggling to keep their medications straight, according to a study conducted by researchers from Harvard Medical School, Brigham and Women’s Hospital, and CVS Caremark.


Among the potential solutions: Create a “pharmacy home” to coordinate pharmacy care from a single point of contact. Researchers also said there is a need to synchronize medication regimens for patients because “those who make numerous trips to the pharmacy to pick up their medications, or fill prescriptions at different pharmacies, may have difficulty taking their medications as prescribed.”


Researchers found that during a three-month period, “10% of patients filled prescriptions for 23 or more medications … and 11 or more different drug classes, had prescriptions written by four or more prescribers, filled these prescriptions at two pharmacies and made 11 or more visits to those pharmacies.”

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CVS explores cause, cost of nonadherence

BY Antoinette Alexander

Industry members would likely agree that those patients who are adherent to their prescription medications use less health care and have lower overall costs; however, how much adherence lowers total costs, why some patients do not take their medications as prescribed and whether what’s saved in health care offsets higher drug costs are among the questions that have not been as clearly understood.


To answer such questions, CVS Caremark inked a multiyear collaboration with Harvard University and Brigham and Women’s Hospital to better understand patient behavior and how the healthcare system can improve it — especially as it relates to medication adherence. Excess healthcare costs due to nonadherence in the United States are estimated to be as much as $300 billion annually. To date, researchers have unearthed a great deal of invaluable data aimed at curbing medication nonadherence. Some highlights appear on the following pages.

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MinuteClinic passes 10 million visits

BY Antoinette Alexander

CVS Caremark’s MinuteClinic continues to evolve and play a greater role in the U.S. healthcare system as evidenced by its expanding footprint, broadening scope of service and growing roster of strategic affiliations.


Since opening its doors in 2000, MinuteClinic has surpassed 10 million patient visits and remains on course to add about 100 clinics annually over the next five years — putting the clinic operator in an ideal position to play an important role in the U.S. healthcare system.


“Healthcare reform is a positive development for retail clinics because there are about 30 million people who are currently uninsured who will have healthcare coverage,” said Andrew Sussman, president of MinuteClinic and SVP and associate chief medical officer of CVS Caremark. “Add to that the aging of the population and the shortage of primary care practitioners, and the opportunity for services such as those provided by MinuteClinic has the potential for growth.”


In fact, MinuteClinic, which currently operates more than 600 locations, already has taken steps to broaden its suite of services. For example, in 2010, it launched a health condition monitoring service for patients with diabetes, high cholesterol, high blood pressure and asthma. In 2011, it began offering vitamin B12 injections and the human papillomavirus vaccination Gardasil.


To help with patient education, it launched earlier this year the Ask Me 3 program, which is designed to enhance communication between healthcare providers and patients in order to improve health outcomes.


“Research shows that patients who understand health instructions get well sooner, tend to take their medication regularly and make fewer mistakes with their care. In particular, clear communication helps individuals do a better job of managing chronic health conditions,” stated MinuteClinic chief nurse practitioner Paulette Thabault, who joined MinuteClinic in July 2010.


Over the past few years, MinuteClinic has formed affiliations with a number of health systems and, since the end of the first quarter 2011, it has added five strategic affiliations to its roster. The company announced No. 11 in August, when it announced its partnership with Indiana University Health, the state’s largest health system.


In addition to patient education and disease state management programs, these partnerships also share the common goal of integrating electronic medical records to streamline communication around a patient’s care for providers on either side of the partnership.

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