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The Cost of Medication Non-Adherence

Natalie
Stein
April 13, 2018
The Cost of Medication Non-Adherence
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Medication Adherence Stats and Trends 

Despite the importance of medication adherence, it is shockingly low in the U.S., with nearly 3 out 4 patients being non-adherent. Furthermore, adherence is lower among individuals with chronic diseases compared to acute conditions.

Consider these additional statistics, compiled in a survey conducted by the National Community Pharmacists Association (NCPA) and Pharmacists for the Protection of Patient Care (P3C).

  • 49%, or nearly one out of two, patients forgot to take at least one of their prescription medications.
  • 31%, or nearly one out of three, patients neglected to fill at least one of their prescribed medications.
  • 24%, or nearly one out of four, patients took a dose lower than what they were supposed to take.
  • 11%, or nearly one in nine, patients took an over-the-counter medication instead of their prescription medication.

Importance of Medication Adherence

The economic and health costs of medication non-adherence are high. An estimate from the Pharmaceutical Research and Manufacturers of America, or PhRMA, puts the annual cost of hospitalizations due to non-adherence at $100 to $300 billion. Each hospital visit costs, on average, an extra $3,575 for a non-adherent patient compared to a hospital visit for a patient who had been compliant.

These are some other statistics demonstrating the importance of medication adherence.

  • Non-adherent hypertensive patients had 17% higher hospitalization and 5.4 times the risk of poor clinical outcomes (e.g., hospitalization and premature death) than adherent patients.
  • Non-adherent hypertensive patients were 7, 13, and 42% more likely to get coronary disease, cerebrovascular disease, and heart failure, respectively, over 3 years than adherent patients.
  • In one study among individuals with diabetes, those who were non-adherent were 2.5 times more likely to be admitted to the hospital than patients who were at least 80% adherent.
  • The risk of hospitalization or death is 2.8 times higher among individuals with dyslipidemia (such as high cholesterol) who are non-adherent compared to those who take their prescription medications as prescribed.

Although one reason patients may not be adherent is because they do not have symptoms from their conditions. Or, they may not realize that the medication is working. However, hypertension is an example of a condition in which each step towards control helps, even if patients do not achieve a "normal" blood pressure. One study found that:

  • The relative risk of heart disease mortality with a systolic blood pressure of 140-149 mm Hg (Stage 1 hypertension) was 4.2 compared to a systolic blood pressure of 110.
  • The relative risk was 20 for a systolic blood pressure over 180 compared to under 110.
  • Each increment decrease of 10 mm Hg of systolic blood pressure was associated with a decreased risk, even when patients did not achieve complete control.
  • Patterns were similar for stroke risk.

Lark health coach can assist with adherence to the medication regimen in a number of ways.

  • Reminding patients to take their medications: when and how much.
  • Connecting patients to healthcare providers when needed.
  • Educating patients on the importance of medication adherence.
  • Tracking patient adherence so patients can see how well they have been following doctor's orders.

In addition, Lark provides coaching to encourage healthy behaviors, including weight management, nutritious eating, getting active, and getting enough sleep. These behaviors can all support general well-being as well as increase patient self-efficacy in taking charge of health and staying adherent to medications to stay as healthy as possible.

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