The National Association of Chain Drug Stores is spotlighting new research that ties medication adherence to avoidable medical expenses.


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Research links Rx adherence, preventable medical costs

July 8th, 2013

ARLINGTON, Va. – The National Association of Chain Drug Stores is spotlighting new research that ties medication adherence to avoidable medical expenses.

NACDS said Monday that research featured on the cover of the July issue of Health Affairs, a health policy journal, finds that innovative approaches to improving medication adherence can help the nation "achieve a higher-performing health system."

The researchers analyzed data for patients with diabetes, heart failure and chronic obstructive pulmonary disease (COPD) who were enrolled in the Medicare Part D prescription drug program. Among key findings, the report revealed that poor medication adherence was related to additional medical and hospital visits resulting in otherwise unnecessary spending for Medicare Part A and B services ranging from $49 to $840 per beneficiary per month.

Besides assessing potential Medicare savings from improved medication compliance, the study — titled "Increasing Medicare Part D Enrollment In Medication Therapy Management Could Improve Health And Lower Costs" — examined the criteria by which Part D beneficiaries are eligible for medication therapy management (MTM) services.

"By combining the two methods, we produce a new metric, 'potentially preventable future costs,' that can be used to target medication therapy management interventions to at-risk beneficiaries with the aim of both improving the quality of care and reducing unnecessary Medicare expenditures," the researchers wrote.

The Medicare Prescription Drug Improvement and Modernization Act of 2003, which established the Part D benefit, requires plans to offer MTM services to beneficiaries with multiple chronic conditions who are taking multiple medications and have high annual drug expenditures. Yet under current eligibility criteria, only a fraction of beneficiaries qualify for these services.

"We believe that potential costs averted should be considered as a criterion for targeting [MTM] interventions and that attention should be given to beneficiaries now excluded from review who display suboptimal adherence patterns associated with the highest Medicare costs," the researchers stated.

Improved medication adherence, they noted, "offers one of those rare opportunities in health care to achieve multiple desirable endpoints from the same policy."

The Health Affairs article was authored by Bruce Stuart, professor in the department of pharmaceutical health services research and director of the Peter Lamy Center on Drug Therapy and Aging at the University of Maryland School of Pharmacy; F. Ellen Loh, graduate research assistant at the university; Pamela Roberto, senior director at the Pharmaceutical Research and Manufacturers of America (PhRMA); and Laura Miller, senior economist at NACDS.

NACDS added that the research comes in the wake of a significant action by the Congressional Budget Office (CBO), which evaluates the financial implications of proposed legislation. Last year, CBO estimated that a rise in the number of prescriptions filled by Medicare beneficiaries "offsets" or lowers spending on other medical services. As a result, CBO will now credit policies that boost the use of medicines with savings on other Medicare services, the association said.

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