Pharmacies step up battle against nonadherence

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It has been said that improved medication adherence is the next blockbuster. That insight has motivated pharmacy operators, drug makers and pharmaceutical distributors, among others, to tackle the problem.

Recent work by three drug chains — industry leaders CVS Caremark and Walgreens, and Thrifty White, which operates 87 stores in six states in the Midwest — shed light on what’s at stake and some of the measures that are being taken to address noncompliance.

CVS Caremark, which has established itself as a leading researcher in the field, published the results of a study about how medication adherence levels affect the productivity of workers, 70% of whom are said to have such health conditions as diabetes, asthma, hypertension and high cholesterol. Conducted together with Truven Health Analytics and published in the Journal of Occupational and Environmental Medicine, the research found that employees who consistently took medicines as prescribed had up to seven fewer days away from work per year than those who were nonadherent, which translated into estimated annual savings of up to $1,700 for each of the individuals who stuck to their medication regimen.

“These research findings clearly show that employees who receive appropriate medical care and follow their doctor’s directions about taking their medication are healthier and more productive,” says Troyen Brennan, a physician who is executive vice president and chief medical officer at CVS Caremark. “These results are one more piece of the puzzle illustrating the impact of medication adherence in improving health outcomes while managing overall health care costs.”

Walgreens is teaming up with the Department of Health and Human Services to develop a medication therapy management (MTM) model to improve outcomes for patients suffering from HIV/AIDS.

The multiyear initiative, to which the retailer is expected to provide about $1 million in in-kind services, will involve Walgreens pharmacists at the drug chain’s HIV Centers of Excellence across the country working intensively with a total of 1,000 patients. Services under the program, which is slated to begin in January, will include comprehensive medication reviews, quarterly MTM, refill reminders, and help managing side effects and dealing with insurers. The data generated will be used to gauge the costs and benefits of such retail pharmacy-based care.

“Walgreens community pharmacists are a valued part of the health care team for thousands of HIV patients coast to coast, and this new program can help elevate the importance and effectiveness of the meaningful patient-pharmacist relationship,” notes Kermit Crawford, the drug chain’s president of pharmacy, health and wellness. “By developing these relationships and closely studying how they impact the outcomes for HIV patients, the collaboration will put community pharmacy in a great position to be even more effective and relevant when it comes to retention in care for those with chronic ­conditions.”

With its new HealthyPackRx compliance packaging, Thrifty White is demonstrating that regional drug chains can play as significant a part in combating nonadherence as their larger counterparts. Patients taking two or more maintenance medications who enroll in the program will receive a 30-day supply of the drugs organized in individual packets labeled with their contents and the day of the week, date and time the medications are to be taken.

By making it simpler and easier for patients to use medications, compliance should increase considerably. That, in turn, should lessen the need for more expensive forms of health care, including visits to physicians’ offices, clinics and emergency rooms, and hospitalizations.

While none of these programs will, in and of themselves, solve the nation’s adherence problem — which a study by the New England Healthcare Institute concluded results in $290 billion a year in unnecessary health care spending — they point to retail pharmacy operators’ resolve to make a meaningful difference. Noncompliance with medication regimens stems from a variety of causes; the tools needed to overcome it will have to be equally diverse.

The good news is that retail pharmacy chains and other health care stakeholders are already hard at work trying to create them.


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