April 24, 2012
The Department of Health and Human Services (HHS) recently sent out a request for information relating to the causes, impact and potential solutions associated with the “the public health problem of prescription medication non-adherence in adults with chronic conditions” (Federal Register, Volume 77, Number 66, April 5). Why is this such a concern? Non-adherence to medicines actually drives up health care costs. In 2009, the New England Healthcare Institute (NEHI) estimated that $290 billion in avoidable medical spending is generated annually by people not taking their medicine. In its report “Thinking Outside the Pillbox,” the NEHI noted that people with diabetes and heart disease are vulnerable to unnecessary hospitalizations when they don’t adhere to their drug regimens. In fact, these populations have double the mortality risk when compared with those who take their drugs as specified.
There are numerous studies that show the economical advantages of taking prescription medicines. One of the most striking to me is a New England Journal of Medicine (NEJM) article which looked at “Expenditures for the care of HIV-infected patients in the era of highly active antiretroviral therapy (HAART).” When HAART (also known as “triple-therapy”) was introduced, the fear was that this very expensive therapy would dramatically drive up the costs of caring for AIDS patients. In fact, the costs of HAART resulted in a 34% increase in the drug costs per patient over previous treatments. However, the overall healthcare expense per patient (including the costs of drugs) dropped by 16%. Obviously, HAART was providing AIDS patients better overall health. More importantly, they were living longer and contributing their skills and energy to society. HAART wasn’t just saving money to the health care system though, it was saving lives.