Prescription medication adherence – taking your medication as prescribed by your doctor – is a simple concept that has become a problem of behemoth proportions in California and nationwide. According to a recent analysis from the New England Healthcare Institute, not taking medications as prescribed leads to poorer health, more frequent hospitalization, a higher risk of death and as much as $290 billion annually in increased medical costs. Unfortunately, there is no one magic bullet to solve the problem. Education, mobile applications and other social media interventions, and phone call reminders from physicians and pharmacists will get you only so far.
Currently pending before the California Assembly is Assembly Bill 2418, legislation that “promotes policies designed to improve patient medication adherence.” The bill specifically addresses pharmacy synchronization, a tried and true methodology for significantly improving compliance and adherence.
Medication synchronization is a pharmacy service that improves patient adherence to prescribed medications by coordinating the refill dates for all of a patient’s chronic prescription medications so they can be picked up on the same date every month. It is estimated that 76 percent of Americans aged 60 and over use two or more medicines and 37 percent take five or more medicines. Patient and caregiver lives are simplified by eliminating multiple trips to the pharmacy each month. It also minimizes confusion over when a prescription is due to be refilled, and minimizes treatment disruptions through delayed or missed refills.
Pharmacy programs such as these seem to be the best way forward, and there’s hard data to back that up. Case in point – the successful Appointment-Based Model (ABM) program being used at Thrifty White, a Midwest chain of pharmacies. The Appointment-Based Model is a voluntary medication synchronization prescription refill program that aims to improve patient adherence as well as the efficiency of the pharmacy operation. The ABM provides enhanced patient access through a streamlined process, opportunity for patient education on medication use, and greater pharmacist oversight to address potential contraindications, duplicate drug therapy, and errors. Patients enrolled in the Thrifty White program have experienced 3.4 to 6.1 times greater adherence.
The outcomes and benefits of so-called medication synchronization programs for California patients are clear: Patients adhere better to physician-prescribed treatment regimens and spend less time doing so. When patients adhere to their treatments, they experience better quality of care and improved health. In addition, increased patient and pharmacist engagement allows for greater monitoring and oversight of patients who take multiple medications.
Medication synchronization also yields benefits for pharmacists in the form of more efficient pharmacy operations. Medication synchronization has the potential to reduce administrative costs incurred by pharmacists and physicians long term as it streamlines medicine refill processes and helps pharmacies manage their inventories.
The American Medical Association adopted Resolution 801(I-12) in 2013, which encouraged relevant organizations, including insurance companies, to implement prescription refill strategies for patients with multiple prescriptions to reduce travel barriers to access to medicines.
The National Community Pharmacists Association (NCPA) has endorsed medication synchronization language for states to use when considering legislation. The National Association of Chain Drug Stores (NACDS) and American Pharmacists Association (APhA) are also educating their members on the benefits of medication synchronization.
According to the U.S. Centers for Medicare and Medicaid Services (CMS), the estimated cost of synchronization to Part D sponsors is meager $0.5million, while the savings to Part D sponsors and beneficiaries is $1.8 billion.And there will be an overwhelming reduction in overall health care costs because of improved patient outcomes due to enhanced medication adherence, which should lead to higher quality ratings for a health insurance plan.
AB 2418 should be a no-brainer for California patients – better health and lower costs.
Peter Pitts is President and co-founder of the Center for Medicine in the Public Interest, and a former Associate Commissioner at the U.S. Food and Drug Administration (FDA).