Prescription Abandonment

You get sick, you go to the doctor, he or she writes you a prescription for some pills, you take it to the pharmacy and then…   Logic would suggest that the next steps would be that you pick up the prescription, take the medicine and get better.

Well, not always.  According to a new study published in the Annals of Internal Medicine almost 2% of these prescriptions are never picked up.

Using databases from a large retail pharmacy chain and a pharmacy benefits manager, researchers examined factors associated with prescription abandonment over a 3-month period.

Unsurprisingly, drugs with high copayments are the most likely to go unclaimed.  Prescriptions with copayments of $40 to $50 and prescriptions costing more than $50 were 3.40 times and 4.68 times more likely, respectively, to be abandoned than prescriptions with no copayment.

In addition, electronic prescriptions were 1.6 times more likely than non-electronic prescriptions to be left behind, and new prescriptions were almost three times more likely to be abandoned than previously filled prescriptions.

Interestingly, young adults were more likely than older patients to abandon their prescriptions, while opiates and anti-platelet agents were the least likely to be left behind.

Although the accompanying editorial called the low rate of abandonment “reassuring,” they suggest that physicians “remain mindful that costs are an important barrier to adherence and should aim to prescribe or recommend less expensive alternatives whenever feasible.”

SRxA’s Advisors can help pharmaceutical companies increase medication compliance and implement programs to lower the consumer cost of prescription drugs. Contact us today for more information.

Putting an “i” in adherence!

Poor adherence to medications has been a bugaboo in the healthcare system for a long time. When sick patients don’t take their meds, they often get even sicker and end up in the hospital.  According to the New England Healthcare Institute, patients who don’t take their medicine when they’re supposed to cost the U.S. healthcare system a mind-boggling $290 billion per year.

This problem caught the attention of entrepreneurs from MIT and physicians affiliated with Harvard Medical School and has led to the creation of several innovative solutions. Among these is an electronic pill box called “Maya” that uses wireless technology and sensors to alert patients with chronic diseases when they don’t take their pills on time.

Another medication-reminder technology is GlowCaps.  These “intelligent” caps fit onto standard pill bottles and use light and sound to signal when it is time to take a pill. They also sense when the bottle is opened and wirelessly relay their status to a secure network. If the bottle is not opened after two hours, the user is automatically reminded with a telephone call.  Additionally, each week, a report summarizing progress is emailed to the user or care-giver. The caps can even call with refill reminders and connect the patient to their pharmacy as pills deplete.

Other solutions include iPhone apps such as MediMemory.

One company has even developed pills that deliver wireless signals after they are swallowed.

Even though such systems have shown to be effective, there’s still a question of who should pay for the technology. “The way that the economic models are currently set up,” says Joseph Kvedar, director of The Partners Healthcare Center for Connected Health , “it’s the patient’s responsibility to take their medication, and nobody will give them a cash subsidy to cover a program like this.”

Given that costs increase dramatically when patients don’t take their drugs, Word on Health suggests it’s about time insurers started paying attention to initiatives such as this.

In the meantime, SRxA’s Health Outcomes group are standing by to help pharmaceutical companies improve patient adherence to their drugs.  Contact SRxA for more information.

Pharma’s Missing Millions

As Word on Health has previously reported, patients not taking or refilling medications on time costs the pharmaceutical industry billions each year.  The recent global economic crisis has helped write a whole new chapter in the adherence story.  Higher numbers of new prescriptions simply go unfilled because patients either cannot afford, or are unwilling, to pay for them.

In the U.S., the total number of prescriptions filled grew a modest 2.7% last year. Yet the rate of prescriptions submitted to a pharmacy but never picked up rose 24%.

According to Dea Belazi, a consulting practice leader for Wolters Kluwer Pharma Solutions,  “What’s peculiar is that the rate of increase among patients walking away is almost unprecedented. Over the last two years, pharma has been trying to understand the abandonment situation, particularly in which parts of the country patients tend to abandon more.”
Among commercial health plan patients, the abandonment rate for new prescriptions at the pharmacy reached 6.3% in 2009. The abandonment rate for new prescriptions of brand-name drugs alone was 8.6%, up 23% from 2008 and nearly 70% since 2006.

Rising co-pays are one reason.  However, macroeconomic factors such as the housing crisis, subsequent recession and lower household incomes are thought to be the main culprits behind rising price sensitivity and soaring abandonment rates.
Health plan denials compound the problem.  Taken together, patient abandonment and payer denials resulted in 14.4% of all new, commercial-plan prescriptions going unfilled in 2009, a 5.5% increase from 2008.
Where can pharma go from here? Abandonment varies geographically. It is highest in Delaware, North Carolina and Florida, whereas denial rates for new prescriptions of brand-name meds are highest in California, Delaware and Florida.

SRxA’s team of world class Health Outcomes experts can help create tactics and strategies to help pharmaceutical companies address abandonment, denial and compliance. Contact us to find out more.