Medication adherence has been called the Achilles heel of modern healthcare.1 The average rate of adherence is only 50% after one year and continues to decline.2,3 It is associated with nearly 70% of all medication-related hospital admissions in the U.S., at an estimated annual cost well over $100 billion.4 Nonadherence issues are particularly troublesome with oral chemotherapeutic medications, which are increasingly entering the market, and which often have severe toxicities and narrow therapeutic indices. A review of adherence published in the Journal of the National Cancer Institute found that up to 80% of cancer patients failed to follow their prescriptions.5
Medication nonadherence leads to unnecessary disease progression and complications, additional doctor visits and hospitalizations, reduced functional abilities, early admission to assisted-care facilities, lower quality of life, and even death. It is called America's other drug problem for good reason.
The Scope and Magnitude of Medication Non-Adherence is Staggering...
- Half of the prescriptions written for chronic diseases are never picked up
- 14% to 21% of patients never fill their original prescriptions6
- 60% cannot identify their own medications6
- Average rate of medication compliance is 50% across all diseases including high severity and high cost chronic diseases7
- 30% to 50% ignore or compromise instructions concerning their medications8
- More than two million serious adverse drug events occur annually due to medication use problems9
…And the Resulting Unnecessary Costs, Negative Effects on Patient Outcomes and Lost Revenues Are Significant
- Non-compliance kills more Americans each year (125,000) than accidents, influenza and pneumonia combined10
- 10% of all hospital admissions (annual cost of $15.2 B); 23% of all nursing home admissions (cost $31.3 B2) – Combined direct costs of admissions & post discharge expenses costs payers $100B annually11
- $43 billion of pharmaceutical sales lost annually snd every percentage point of compliance for statins is worth $73m/yr11
- Overall cost to US Healthcare system alone of $250+ billion year in unnecessary expenses12
And The Problem Is Getting Even More Serious for All Stakeholders
- The US population is getting older and sicker while more people are getting added to the insurance rolls and there is less money to pay for care.
- Drugs are getting more specialized, more expensive and are administered more frequently by patients themselves outside the hospital or doctor's office.
- Healthcare is moving to a more "accountable" or value-based delivery model where reimbursement is more tightly aligned to quality outcomes.
References:1 Vermeire E, Hearnshaw H, Van Royen P et al. Patient adherence to treatment: three decades of research. A comprehensive review. Journal of Clinical Pharmacy and Therapeutics 2002;26:331-342.
2 World Health Organization. Adherence to long-term therapies. Evidence for action. 2003. www.emro.who.int/ncd/Publications/adherence_report.pdf (accessed 2007 Jun 20).
3 DiMatteo MR. Variations in patients' adherence to medical recommendations. A quantitative review of 50 years of research. Med Care. 2004; 42:200-9.
4 Osterberg L, Blaschke T. Adherence to medication. New England Journal of Medicine 2005;353:487-497.
5 Partridge, AH, Avorn, J, Wang, PS, Winer, EP. Adherence to Therapy With Oral Antineoplastic Agents. Journal of the National Cancer Institute, Vol. 94, No. 9, 652-661, May 1, 2002 Oxford University Press.
6 FDA and National Council on Patient Information and Education
7 World Health Organization (WHO)
8 CDC (Center of Disease Control) and the AHA (American Heart Assoc)
9 Institute of Medicine (IOM)
10 National Pharmaceutical Association
11 Vermiere E, Hearnshaw H, Van Royen P, Denekens J. Patient adherence to treatment: three decades of research: a comprehensive review
12 The New England Healthcare Institue and Express Scripts Drug Trend Report 2010