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Solutions for Improving Medication Nonadherence Costs

Posted by The CareSync Team

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Aug 15, 2017 11:36:36 AM

Physicians are searching for solutions for improving medication nonadherence costs and readmission rates among patients.Finding solutions for improving medication nonadherence costs, which total billions of dollars each year, is a top healthcare priority. How can you help get patients back on track with medication adherence?

An estimated 20% to 30% of prescription drugs are never filled, and approximately 50% of drugs prescribed for chronic conditions are not taken properly.

Not only can medication nonadherence alter a patient’s success with their care plan, but medication nonadherence costs are also serious in terms of dollars and lives. Each year, prescription nonadherence causes 125,000 U.S. deaths, is responsible for at least 10% of hospital admissions, costs $2,000 per patient in physician visits, and costs the U.S. between $100 - $290 billion.

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Reasons for Medication Nonadherence

There are many reasons patients might give for not taking their medications or not taking them correctly, including:

  • I missed a dose and didn’t know what to do about it
  • I waited too long to refill the prescription
  • I never picked the prescription up
  • I just decided to stop taking them
  • My prescription expired and I didn’t contact my doctor to renew it
  • My prescription expired and I didn’t have the money to go back to the doctor’s office
  • My medications cost too much
  • My medications aren’t covered by insurance
  • I don’t know what the medication is for/why I need it
  • I don’t understand how to take the medication

Medication Nonadherence Costs Are Growing But You Can Help

Improving Medication Nonadherence Costs: Why healthcare is focusing on getting rates of medication compliance higher

Although improving medication nonadherence costs is a major challenge, there are steps you can take as a physician or caregiver to help patients comply with their medication regimen. To help encourage patient medication compliance, consider these options:

  • Ask the patient to use a series of alarms to alert them when it’s time to take their medications
  • Encourage the patient to use a software app that sends them reminders through their phone or computer app
  • Look for trends in medication nonadherence to see if you can identify triggers that lead to lower medication compliance (for example, do the prescriptions they tend to skip happen to be larger pills that may not be easy to swallow?)
  • Use daily or weekly pill boxes to organize medications, track their use, and help them avoid taking a double dose when they think they’ve missed a medication, but haven’t
  • Encourage caregiver or family member support, by asking someone to regularly check with the patient to see if he or she is taking their medications correctly
Caregivers and family members can be great partners for physicians with the goal of improving medication nonadherence costs.
  • Identify options to help the patient save money on prescriptions, such as payment assistance programs or setting them up with a pharmacy discount program
  • Make sure questions about medications are answered fully so they know why they need the medicine and are clear on how to take it (setting them up with a pharmacist consultation may help, or getting them an appointment with a diabetes educator to learn the proper way to take their insulin)

Whenever possible, leverage help from your Physician’s Assistant or front office staff to support implementing these options to aid in improving medication nonadherence costs.

Cost Barriers to Patient Medication Adherence

Learn about the current state of Chronic Care Management by clicking here.Additionally, you can be proactive in helping patients adhere to their medication regimen by helping to remove cost barriers. For example, has the practice staff checked the prescription against the patient’s insurance to see if it is covered? If not, does the doctor have an alternative option that is covered by the insurance? Is there a less costly generic version that would work? Addressing those obstacles ahead of time could help avoid surprises at the pharmacy counter that may make the patient skip getting their medications filled.

Use Care Coordination Services to Improve Medication Adherence

Another option is to consider enrolling the patient in Medicare’s Chronic Care Management program or other care coordination services to help mitigate patient non-compliance and support medication adherence. Care coordinators can help identify lower cost options for prescriptions, follow up with patients for care plan and medication adherence, and help identify patients who are likely to engage in medication nonadherence so the physician can take action early, before the problem leads to more complications and increased medication nonadherence costs.

For more information about Medicare Chronic Care Management, care coordination, MACRA, MIPS, and other CMS requirements that impact reimbursement and healthcare, download this free CCM white paper by CareSync.

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