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CVS: Patients who don't take meds boost health care costs Posted: July 10th, 2013

By Beth Orenstein

Beth Orenstein is a freelance writer from Northampton, Pa. A graduate of Tufts University, she covers health topics.

If patients were to take their medicine as prescribed, it would save hundreds of millions of dollars in health care costs nationwide, according to a new report by CVS Caremark based in Woonsocket, R.I.

The recent report by the pharmacy and benefits manager found the potential cost savings by state ranged from $19 million to $2.1 billion a year.

The report looked at four common health conditions: diabetes, high blood pressure, high cholesterol and depression.

It used CVS Caremark's pharmacy benefit management business to examine medication adherence rates and the use of generic drugs for these conditions on a state-by-state basis.

Three market segments examined

The report also looked at three distinct market segments: health insurance plans, employer-sponsored plans and Medicare Part D prescription drug plans.

Among its findings:

  • Patients with depression had the lowest adherence rate, whether they had their own health insurance, an employer-sponsored plan or Medicare Part D.
  • Patients with high blood pressure were the most adherent across all market segments.
  • Medicare beneficiaries had the highest adherence rates across the three insurance groups.
  • Employer-sponsored health insurance plans had the highest rates of dispensing 90-day prescriptions.

Adherence data state-specific

The report looked at different factors to determine adherence rates. One was the percent of plan members who are persistent in refilling their prescriptions.
The report found that Pennsylvania had the highest refill rate among those who belong to health plans (79.8 percent); Vermont had the highest refill rate among employer-sponsored plans (81.1 percent); and New Jersey had the highest refill rate among Medicare beneficiaries (94.2 percent).

Regional variations found

While state-specific data was the focus of the report, it also found regional variations:

  • The Midwest had the lowest adherence rates for health plan members with diabetes and depression.
  • The South had the lowest adherence rates for patients with any condition in employer-sponsored plans and Medicare Part D.

CVS chief advocates interventions

The researchers used a proprietary pharmacy care economic model to calculate the potential cost savings that could be achieved by improving medication adherence and reducing unnecessary health-care interventions for each state.

In a press release on the survey results, Dr. Troyen A. Brennan, executive vice president and chief medical officer of CVS Caremark, said the data demonstrates the need for increased adoption of interventions that can improve medication adherence. Troyen said improving adherence would "advance health outcomes for patients and less the cost burden for the health-care system."

The report also said that pharmacist counseling is cost-effective and contributes to improved adherence.