WOONSOCKET, R.I. — By 2017, CVS Health aims to raise medication adherence among its millions of patients by 5% to 15% through new interventions.
 |
CVS outlined its goal Thursday with the release of a new Insights Report titled, "Adherence: Why It’s So Hard and What We Can Do About It." The report, by the CVS Health Research Institute, highlights CVS’ extensive study of medication nonadherence, key findings about why people stray from their prescription regimen, and the company’s efforts to boost adherence.
"The reasons why people don’t take their medications for chronic conditions as prescribed by their health care provider are very personal and complex," CVS Health chief scientific officer William Shrank said in a statement. "Over the past several years, CVS Health has invested in research to help the industry better understand medication nonadherence. Our goal now is to apply this knowledge and develop new interventions that will enable us to improve adherence for the patients we support."
In the report, CVS noted that almost half of people taking a medication for a chronic disease stop doing so in the first year, with the biggest drop-off in the first month. Among patients on statin drugs, more than 50% stop taking their medicine in the first year.
According to an estimate by the New England Healthcare Institute, the annual cost of medication nonadherence in the United States is $290 billion, the report pointed out.
The Insights Report focuses on four key areas of CVS Health adherence research and spotlights programs and initiatives to address identified issues. Those areas include primary nonadherence, when patients don’t pick up their first fill for a prescription; pharmacist counseling and support, including innovations implemented by CVS Health to enable effective consultation at its retail pharmacies; improving adherence at home, by supporting patients in their daily medication regimens on an individual basis; and the role of pharmacy benefit plan designs, which can help reduce barriers such as cost, medication complexity and forgetfulness.
Key medication adherence research findings highlighted in the report include the following:
• 46% of all patients don’t understand prescription dosing instructions.
• It has been estimated that up to a third of prescriptions written are never filled.
• Each additional dose that a patient must take in a day can reduce adherence by as much as 2%.
• The relative influence on Rx adherence is 34% for prescribers, 40% for patients and 26% for pharmacists.
• Face-to-face counseling by a pharmacist is two to three times more effective at improving patient adherence than other interventions.
• Adherence commonly decreases when patients become covered by a high-deductible health insurance plan.
Ways to increase adherence, according the Insights Report, include point-of-prescribing messaging to reduce "sticker shock" at the pharmacy counter, electronic prescribing and electronic prior authorizations to facilitate prescription filling and delivering patient prescription information directly to an electronic health record (EHR) to help identify instances of nonadherence.
Other avenues for promoting adherence, the report said, are convenient, one-on-one medication counseling with a pharmacist; shifting patients to 90-day medication supplies when appropriate; prescription synchronization to facilitate pickup of multiple medications; refill reminders and automatic refills/renewals; and value-based insurance designs (VBID) that lower costs for services and prescriptions shown to improve patient health outcomes.
CVS noted, for example, that it has interacted with millions of patients through its Pharmacy Advisor program and made significant improvements in adherence. Compared to control groups, 10% more members achieved optimal adherence with counseling via the program.
"We are actively piloting and testing a number of interventions to help make it easier for our patients to be more adherent," Shrank added. "For example, we know through our research that it is difficult for patients to be optimally adherent when they have numerous health care providers, take multiple medications with different dosing regimens, and make several trips a month to the pharmacy to pick up prescriptions. As a result, we are actively engaged in a variety of pilots to test prescription synchronization programs and innovative medication labeling and packaging."
The report reflects CVS’ long-term study of the issue of medication adherence. Over the last 10 years, in collaboration with researchers at Harvard University, Brigham and Women’s Hospital, the University of Pennsylvania and other institutions, the company has published or presented more than 50 adherence-focused papers in peer-reviewed journals and clinical conferences.
Overall, CVS Health provides pharmacy benefit management services to nearly 65 million Americans, serves over 5 million customers a day at its CVS/pharmacy retail drug stores and supports almost a million patients with complex or rare conditions through its specialty pharmacy services. In addition, the company’s MinuteClinic walk-in medical clinics have tallied more than 20 million patient visits since 2000.
