Nonadherence top culprit in health care waste
Pharmacists can provide solutions to $290 billion problem.
Poor medication adherence is one of the greatest waste culprits in
modern health care, according to a new report from NEHI, the New England
Healthcare Institute. “Thinking
Outside the Pillbox: A System-wide Approach to Improving Patient
Medication Adherence for Chronic Disease” provides
solutions to improving medication adherence, particularly among patients
with chronic disease, and specifically names pharmacists as one of the
key purveyors of solutions to this vexing problem.
The brief builds on a 2007 NEHI study, “Waste and Inefficiency
in the Health Care System,” which maintained that one-third of the
$2.4 trillion spent on health care in the U.S. could be eliminated
without reducing quality of care. Overall, 75% of health care spending
in the U.S. goes to treat chronic disease.
Patients with chronic diseases who are not vigilant about adherence
are especially vulnerable to preventable worsening of their conditions.
This in turn causes expensive medical care down the line. According to
the brief, patients with diabetes and low levels of adherence have
nearly twice the average total annual health care costs as
high-adherence patients ($16,498 versus $8,886). Employers are also
affected; an average mid-sized company with $10 million in claims will
see $1 million in avoidable health care spending.
All of these figures add up; as recent debates in health care reform
have centered on economic viability of care models, advocating for
improved medication adherence and collaborative strategies to achieve
these goals has never been timelier.
The NEHI brief offers concrete solutions that public and private
policymakers can use as ammunition when addressing the issue of
medication adherence in health reform efforts. Strategies that were put
forth in the brief included: creating health care teams, which would
prominently feature pharmacists; educational counseling of patients by
primary care providers or pharmacists; payment reform (realigning
reimbursement incentives to encourage providers to invest in resources
such as counseling services); and employing health information
technologies, such as electronic health records, e-prescribing, and
clinical decision support systems to support adherence initiatives.
Related resources on www.pharmacist.com
Beth Farnstrom (bfarnstrom)
Posted August 19, 2009, 5:00 pm EDT
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