Study Finds Medication Adherence Associated with Overall Lower Medical Costs

ST. PAUL, Minn., April 27, 2011 /PRNewswire/ -- Individuals with diabetes who adhere to their medication had lower risk of hospitalization by one-third when compared to patients who do not adhere to their medication, according to a new study. The results of the study by Prime Therapeutics (Prime), a thought leader in pharmacy benefit management, are being presented the last week in April at the Academy of Managed Care Pharmacy's 23rd Annual Meeting and Showcase in Minneapolis, Minn.

More than 23 million Americans have been diagnosed with diabetes mellitus (DM), commonly known as diabetes, and each year another 1.6 million people are diagnosed with the condition.  Poor medication adherence has been associated with worse medical outcomes and increased medical costs for patients with diabetes in a single employer or the elderly. Until now, there has been little data quantifying the potential value of improved outcomes and costs possible with better medication adherence in a large commercially insured population. In this study, one of the largest of its kind, more than 15,000 commercially insured individuals with a diabetes diagnosis medical claim were followed for one year.

"Our research found adherent individuals had $1,010 lower medical costs during the year," said Patrick Gleason, PharmD, director of Clinical Outcomes Assessment at Prime. "Besides the medical cost savings, patients that adhere to their medications are likely to have improved health and increased quality of life. Yet in this study, we found one-quarter of patients do not stick to their diabetes medication, so the medical community must find ways to increase adherence for those most at-risk."

Researchers from Prime and one of its Blue Cross and Blue Shield clients reviewed pharmacy and medical claims from a commercial medical plan with 1.3 million members. The study identified individuals continuously enrolled between 2007 and 2009. Researchers then focused on members who had either two separate office visits for diabetes or a diabetes-related hospitalization in 2008 and with a DM medication supply or a diagnosis of diabetes with microvascular disease. All medical and pharmacy claim costs were added up to determine the total cost of care.

A total of 15,043 members were followed for one year. Of that group, 73.9 percent (11,108 members) were adherent to their medication and 26.1 percent (3,935 members) were non-adherent. While those individuals adherent to DM medication had higher pharmacy costs which led to an increase in the overall total cost of care ($572), those adhering to medications were found to have a 31 percent lower risk of hospitalization and significantly lower overall medical costs ($1,010) than the non-adherent group.

The published study abstract can be found in the Journal of Managed Care Pharmacy 2011;17(3):244.

http://www.amcp.org/amcp.ark?c=jmcp&sc=articles&year=2011&volume=17&issue=3

Prime Therapeutics is a pharmacy benefit management company dedicated to providing innovative, clinically-based, cost-effective pharmacy solutions for clients and members. Providing pharmacy benefit services nationwide to nearly 17 million covered lives, its client base includes Blue Cross and Blue Shield Plans, employer and union groups, and third-party administrators. Headquartered in St. Paul, Minnesota, Prime Therapeutics is collectively owned by 12 Blue Cross and Blue Shield Plans, subsidiaries or affiliates of those Plans. Learn more at www.primetherapeutics.com.

SOURCE Prime Therapeutics

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