Medicines Play an Important Role in Controlling Health Care Costs

New Health Affairs Study Strengthens Argument For Policies to Improve Medication Adherence

07.08.13 | By

Research shows that properly adhering to medications is a major challenge, but patients who take their medications as prescribed are more likely to have better outcomes. Today, a new study published in Health Affairs offers further proof of the important role medicines play in controlling healthcare costs and demonstrates the consequences of not taking medicines as recommended.

Among the key findings of this new research, which was co-authored by the University of Maryland, NACDS, and PhRMA, Medicare Part D beneficiaries with poor medication adherence experience higher spending on Medicare Part A and B services, ranging from $49 to $840 per beneficiary per month. For all three of the chronic conditions examined—diabetes, heart failure, and COPD—the study demonstrates that consistently high adherers had lower medical and hospital costs than non-adherent beneficiaries. 

So how exactly do you help Medicare beneficiaries better adhere to their prescription medications? One option is medicine therapy management (MTM) services, which Part D plans  are required to offer to beneficiaries who have high prescription medication spending, a minimum of two to three chronic conditions, and are taking two to eight different Part D-covered medications. 

In addition to the current MTM eligibility criteria, the study also considers a new metric, which the authors term “potentially preventable future costs.” This criterion could be used to target MTM services for beneficiaries who are at risk for otherwise avoidable high cost services such as hospitalizations with the goal of not only improving the quality of care for patients, but also reducing unnecessary Medicare expenditures.

We spend a lot of time talking about the value that medicines bring to patients and the healthcare system.  This study supports the important role that medication adherence plays in improving health outcomes and controlling healthcare costs. 

Relatedly, PhRMA is also a partner of the Prescriptions for a Healthy America coalition that is dedicated to improving medication adherence rates. The coalition is comprised of patients, healthcare providers, pharmacy organizations, consumers, and healthcare industry leaders. We hope that this coalition will be a driving force in offering policy solutions to America’s adherence challenge.

Check out more on Prescriptions for a Healthy America.   



Hide Comments

More On PhRMA — powered by PhRMApedia


Cost in Context