One successful strategy for employers and health plans wishing to cut spending on their employees or members with chronic diseases is to implement ways of encouraging strong medication adherence. In a poster presentation led by Patty M. Fong, PharmD, researchers from American Health Care plan, Rocklin, CA, have demonstrated that the degree of a patient’s medication adherence inversely correlates with the amount of total healthcare dollars spent on that patient.
Using pharmacy claim data, the team evaluated the correlation between several levels of medication adherence and the amount of medical costs in patients with 1 of 3 chronic diseases over a 12-month period. They divided 4999 patients with hypertension (N = 2610), dyslipidemia (N = 1669), or diabetes (N = 720) into 1 of 5 groups according to the level of their medication adherence, based on medication possession ratio (MPR).
Cost measures included prescription costs, medical costs, and total healthcare costs. In each disease state, >75% of patients had an MPR between 80% and 100%. Greater medication adherence across all 3 disease states was associated with significantly lower medical and total healthcare costs, even as total prescription costs were highest among the most medicationadherent patients.
The strongest correlation was found in patients with dyslipidemia, in which annual prescription costs ranged from $1259 for the least adherent patients to $2252 for the most adherent. In contrast, annual medical cost was $2869 for the most adherent patients compared with $12,393 for the least adherent patients, amounting to total annual healthcare costs of $5121 for the most adherent compared with $13,653 for the least adherent patients.
The same inverse trend was seen in the patients with hypertension or diabetes; however, in the case of diabetes, the most adherent patients also had the highest total healthcare costs—$11,950—of all patients with an MPR between 80% and 100%, which “makes patients with diabetes part of the 5% of the total population who contribute to 75% of healthcare costs,” Dr Fong and colleagues observed.