Former Surgeon General C. Everett Koop said it best: “Drugs don’t work in patients who don’t take them.” Unfortunately, many patients don’t take their drugs. Health care providers, third-party payers, and pharmaceutical companies have taken notice. They’re studying the issue of non-adherence and looking for solutions to the problem. Sharps Compliance is an active partner in this effort.
Human & Financial Costs of Prescription Non-Adherence
In 2018, the Food and Drug Administration (FDA) set a record when its Center for Drug Evaluation and Research (CDER) approved a record 59 novel drugs and biologics. Of these drugs, 58% were orphan drugs, and 24% were “breakthrough therapy” drugs designed to treat serious or life-threatening conditions.
Although Americans increasingly have access to more effective drugs, 20-30% of patients never actually fill their prescriptions, no matter what type of drug is prescribed. Even if they do fill the prescriptions, up to 50% of patients don’t take their medications as prescribed. The human costs are high:
The Centers for Disease Control and Prevention (CDC) estimates that non-adherence causes 30 to 50 percent of chronic disease treatment failures and 125,000 deaths per year in this country. Twenty five to 50 percent of patients being treated with statins (cholesterol lowering medications) who stop their therapy within one year have up to a 25 percent increased risk for dying.
Non-compliance isn’t just bad for patients’ health; it increases the country’s already high health care costs.
- $290 billion annually in “avoidable medical spending”
- $1.5 billion annually in lost wages
- $50 billion annually in lost worker productivity
Sicker patients cost more to treat because they may require hospitalization, surgeries, or long-term care. Better patient adherence would help prevent these situations.
Why Don’t People Take Their Medications?
There are as many reasons as there are patients, but there are several broad categories.
- Confusion due to multiple medications: Consumer Reports found that over 1/3 of Americans over age 55 were taking more than five different prescription medications, and 9% were taking 10 or more. It’s hard for some people to keep up with what to take and when.
- Side effects: Many drugs have side effects, and patients just stop taking them instead of discussing the issue with their doctors.
- Financial difficulty: The CDC reported that in 2013, 7.8% of Americans didn’t take medications as prescribed as an effort to save money.
- Low health literacy: Patients may not realize how important the medication is to maintain good health and/or avoid deterioration from chronic illnesses like diabetes.
People with chronic illnesses represent a substantial segment of the non-adherence population. Their conditions don’t immediately present life-threatening symptoms (or any symptoms at all), so it’s easier to dismiss the importance of their medications. For example, someone with a food allergy may need to use an EpiPen immediately after ingesting an allergen. There’s a definite cause and effect. However, a patient with high blood pressure doesn’t suffer a stroke every time they over-exert, and a diabetic probably won’t lapse into a coma after eating a glazed donut.
Yet, long-term, they’re placing their health at risk each time they forget or forgo their medication.
Improving Patient Outcomes with Education & Data Collection
Researchers have found that patient education can be a “key factor in helping patients with diabetes better stick to their drug treatment plans.” Patients who are knowledgeable about their conditions are more likely to follow their treatment regimens.
The three most motivating factors that patients identified were their knowledge that diabetes medications work effectively to lower blood glucose, understanding how they could manage side effects of their medications and a better understanding of the drugs’ benefits.
Targeted research has also shown that two sessions of counseling increased the adherence of patients taking injectable insulin by 24% compared to patients who received no counseling.
Monitoring patient compliance as part of a formal study is relatively easy, but it’s more difficult to track adherence in larger patient populations. Common monitoring and data collection solutions include:
- Electronic Medical Records (EMRs), which allow tracking via claims and pharmacy refills.
- Patients’ ability to self-report using diaries and questionnaires.
- Software that cross-references patients’ adherence information with their medical records and alerts care providers to anomalies.
Medical professionals should look for ways to encourage and monitor patient adherence. The data collected gives stakeholders across the continuum of care valuable information that helps them create better treatment protocols.
Full-Spectrum Adherence Management with Sharps Compliance
Sharps Compliance offers a monitoring and data collection option for patients who self-inject at home. Our Patient Support Program is the only medical waste program that conducts a waste analysis and collects pertinent data.
The goal is to generate data that can compare compliance between drug types as well as compare outcomes. More sophisticated data will help identify those patients most likely to be non-compliant as well as show how an individual product meets the needs of a specific patient. Patients, pharmacy personnel, and providers can use the data to develop strategies for monitoring adherence and improving outcomes:
- Increased patient education and communication
- Adjustment of dosage regimens to match patient preferences and lifestyle
- Automatic reminders using personal or electronic communications
- Automatic prescription refills
- Creation of incentive programs to boost adherence
These advances rely on a large, reliable data collection methodology that pools information from a large variety of sources instead of just internal reporting. When the data reflects very broad populations, it’s easier for providers and pharmaceutical companies to draw conclusions and locate areas where prescription drug regimens are not providing the expected outcomes. The analysis and application of this data can help providers develop better individual care plans. Instead of a one-size-fits-all approach, they can treat individuals and determine the right course of therapy for the right patient at the right time.
The Patient Support Program can help pharmaceutical companies build value-added relationships with third-party payers and act as partners in care – a relationship that can have a tremendous influence on formulary decisions. Pharmaceutical companies can become active partners in meeting the shared healthcare challenge of providing the best care for each patient while improving outcomes and reducing costs.
Sharps’ Patient Support Program provides patients with safe sharps containment and disposal solutions that help providers monitor and improve patient compliance with injectable medication regimens. Learn more in our white paper, “Sitting on a Data Mine” or contact us.