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90-day refills spur Rx adherence, Walgreens finds
November 7th, 2012
DEERFIELD, Ill. – Research from Walgreen Co. revealed that Medicaid patients with 90-day refills showed better medication adherence than those with 30-day refills.
Walgreens said Wednesday the study also found that Medicaid patients with 90-day refills had greater persistency, nominal wastage and more cost savings.
Titled "Medication Days' Supply, Adherence, Wastage, and Cost Among Chronic Patients in Medicaid," the study was published in the 2012 Vol. 2 issue of Medicare & Medicaid Research Review and assessed the impact of 90-day medication refills at community pharmacies compared with 30-day refills for Medicaid patients.
In comparison to patients with 30-day refills, those using 90-day refills at community pharmacies showed 20% higher adherence, 23% higher persistency, and a projected savings of $13.95 per patient per year after removing wastage costs and adjusting for the effects of age, gender and comorbidity.
"Our 90-day refill program at our community pharmacies is an innovative health care solution that can help lower costs and improve patient outcomes," Jeffrey Kang, senior vice president of pharmacy, health and wellness services and solutions at Walgreens, said in a statement.
"At the time of our study, only 13 states gave Medicaid patients the option to receive a 90-day medication supply. However, with the growing popularity and adoption of 90-day refills at community pharmacies, more and more Medicaid patients have an opportunity to benefit from face-to-face pharmacist interaction and the personalized care our pharmacists provide," Kang explained. "Both patients and the health care system could benefit from re-examination of these broad state dispensing limitations."
Walgreens noted that the study's release comes as states attempt to rein in Medicaid pharmacy costs by setting dispensing limits on medication days' supply (most have a limit of 34 days) in order to limit medication wastage. The company said results show that wastage can be nominal across the 30-day and 90-day channels and that three-month fills at community pharmacies could significantly improve outcomes and lower costs among Medicaid patients.
Many of these Medicaid patients include those with chronic conditions who often face major socioeconomic challenges affecting their ability to stick to their medication therapy. Citing other research, Walgreens reported that 45% of Medicaid beneficiaries have three or more chronic illnesses, and that population represents 75% of total Medicare costs.
For the Medication Days' Supply study, 52,898 patients prescribed to statin, antihypertensive, selective serotonin reuptake inhibitor (SSRI) or oral hypoglycemic medications were identified using California Medicaid claims from Walgreens in January 2010. Adherence is a measurement of how often patients take their medications as prescribed, and persistency is the length of time patients continue taking their medications. Medication wastage is defined as a switch of drug or drug strength in the same therapeutic class that occurred before the expected refill date.