CVS said Monday that a new study from the CVS Health Research Institute, published in The American Journal of Managed Care, also found a greater opportunity for savings if medication adherence resources focus on patients with three or more chronic co-morbidities, such as hypertension, diabetes and high cholesterol.
A preliminary analysis showed that payers could save $38 million to $63 million per 100,000 members by targeting resources at these patient populations, the company reported.
“There is extensive evidence supporting the relationship between better adherence, improved health outcomes and reduced health care costs. But efforts to improve medication adherence, while effective, can be costly,” CVS Health chief medical officer Troyen Brennan said in a statement. “We are now trying to better understand how to maximize health care resources to have the greatest impact on adherence and provide the maximum benefit for payers and patients.
“This research indicates that targeting adherence interventions to patients based upon their adherence history and co-morbidities would result in greater cost savings and a better use of health care resources,” he explained.
In the study, researchers reviewed de-identified medical and pharmacy claims data of more than 1.2 million patients with at least one of three chronic diseases — including diabetes, hypertension and high cholesterol — over a two-year period. The study found that the best strategy was to focus on patients who are adherent and to keep them adherent.
For example, a patient with hypertension who was initially adherent but became nonadherent spent another $2,663 on medical care. Researchers also discovered that the number of co-morbid conditions directly influenced the amount of cost savings when adherence behavior improved; patients with three or more chronic conditions had up to seven times greater savings than patients with one or two conditions.
“Short-term changes in adherence can have a meaningful and immediate impact on health care costs, and this kind of research is important in helping our clients understand the value of medication adherence and where the greatest cost-savings opportunities exist for their member populations when it comes to maintaining medication adherence,” stated Jonathan Roberts, president of CVS Caremark, the pharmacy benefit management unit of CVS Health. “We have a number of analytic tools that we use with our clients and offer adherence programs tailored for specific member populations to help improve health outcomes and deliver significant value for our clients.”
CVS Health noted that it uses predictive analytics to understand which patients are likely to be nonadherent and works with clients to target member populations who can benefit most from adherence programs. CVS said it recently launched Care 1-on-1, a program that connects members with multiple chronic conditions to a dedicated pharmacy care team that’s available 24/7 to coordinate medication delivery and address adherence issues.