NEHI beats a drum for improved medication adherence throughout healthcare

NEHI (Cambridge, MA), a public-policy institute, has tagged improved medication adherence as a national priority for several years now, having estimated the cost to the healthcare system from poor adherence to be $290 billion in 2009. A newly published report, Six Priorities for Action to Support Patient Medication Adherence, reiterates goals around which industry, providers, payers and government can unite:

• Promoting sharing of best practices and lessons learned from pilots of new medication management techniques
• Supporting large-scale implementation of promising, evidence-based “tactics” for improved medication management
• Continuing development of metrics of medication use to spur adoption of proven medication management strategies
• Accelerating adoption of electronic prescribing and electronic medical records that support evidence-based interventions for improved adherence
• Improving Medication Therapy Management services in Medicare Part D
• Integrating medication adherence research, policy development and advocacy with broader efforts that aim to improve use of medicines, including those focused on patient safety.

A 2012 study, from Capgemini, estimated a loss of over $188 billion in lost pharma revenue from poor adherence—which is roughly two-thirds the value of all US pharma sales. And there’s the rub: historically, providers and payers have looked on pharma’s input in adherence as being self-serving. But that attitude is changing, in part because of the renewed forcus of the Affordable Care Act on outcomes- or value-based medical care.

“Historically we’ve treated medicines as a category of medical expenditure that needs to be managed, not as an asset that can be optimized to yield optimal outcomes at an optimal total cost of care,” says Tom Hubbard, VP of policy research at NEHI. “That’s changing now,” he says, noting that a change in Congressional Budget Office analysis occurred late last year, enabling CBO to include the health cost savings of medicine use in budget estimates—and not just the cost of those medicines.

Physicians Interactive (Reading, MA), one of many marketing services companies for pharma, is executing on the evidence-based tactics that NEHI highlights. By including predictive analytics (of how patients will comply with treatment regimens) along with educational and financial support (in the form of coupons and other patient assistance) in the workflow of physicians, pharma support of adherence can become an asset to providers and payers, says Gene Guselli, president of global operations at the firm. In its most refined form (which Guselli says is being put into use at some provider sites), the patient support tools are integrated into the electronic health record (EHR) systems at the site, giving physicians timely reports on refills and other adherence measures. “Physicians can move from prescribing drugs to prescribing adherence,” he boasts.