Prime study shows individuals with high cholesterol who adhere to their statin medication are healthier but have higher overall costs

The study found individuals adherent to statin medication went to the hospital or emergency department 2.6 percent less often than non-adherent individuals, resulting in medical costs that were 7 percent lower (a difference of $767). The lower medical costs, however, were offset by pharmacy costs that were 45 percent higher (a difference of $1,606).

This conclusion varies from earlier studies that showed individuals adherent to their cholesterol medication had a lower total cost of care because their lower medical costs more than offset their higher pharmacy costs. The reason for the difference identified in this study may be due to population differences, including younger age, according to the authors.

"This study is a continuation of our collaborative work with Blue Cross into understanding the connection between adherence and total cost of health care, including hospitalizations," said Pat Gleason, PharmD, FCCP, BCPS, director of clinical outcomes assessment with Prime. "With the increasing availability of generic statins, especially the generic atorvastatin of the brand Lipitor, the higher pharmacy costs we found may be lowered. In this study, adherence to statins was associated with lower medical costs and hospitalizations, two very important outcomes that will help up us recommend solutions that lead to healthier outcomes for individuals."

In the study, researchers from Prime and Blue Cross compared medical and pharmacy costs among individuals with high cholesterol who were adherent to their statin medication to individuals who were not adherent ("adherence" was defined as following the medication regime 80 percent of the time or more). Of the 45,869 members included in the study, 21,693 (47.3%) were adherent and 24,176 (52.7%) non-adherent during the two-year follow-up period.

Prime's expertise and insight on managing pharmacy benefits is driven by its strong clinical foundation and unique connection with health plans. Prime applies this insight to deliver the best health outcomes for its members.

About Prime Therapeutics

At Prime Therapeutics, people are at the center of all we do and every decision we make. As a leader in pharmacy benefit management, Prime is dedicated to making it easier for our members to obtain more affordable medicines. We collaborate with health plans, employers and plan providers to deliver programs coordinated across pharmacy and medical benefits that lead to the best health outcomes for our members.

Prime's integrated pharmacy benefit management services include claims processing, benefit plan design, network management, clinical program consultation, rebate management, formulary administration, mail-service pharmacy and specialty pharmacy.

Headquartered in St. Paul, Minn., Prime Therapeutics serves nearly 20 million people and is collectively owned by 13 Blue Cross and Blue Shield Plans, subsidiaries or affiliates of those Plans. Prime has been recognized as one of the fastest-growing private companies in the nation by Inc. 5000 and as a most engaged workplace by Achievers.

For more information, visit www.primetherapeutics.com or follow @Prime_PBM on Twitter.

SOURCE Prime Therapeutics