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Human and Economic Impact of Medication Non-Compliance

Medication Non-Compliance:

  • Costs $177 Billion in US annually (approximately a quarter of total annual pharmaceutical revenues) 1
  • Low adherence represents an average drug loss of 36% in potential sales 1
  • Accounts for 78% of healthcare spending 2
  • 20-25% of employer healthcare costs are the result of non-compliance 3
  • 50% of people with a chronic illness are non-compliant 4
  • Cuts across age, gender, race, education and income 5
  • Effective adherence programs may have a much greater impact on patient health than improved medical treatments 4

Medication Adherence:

  • Better adherence to antihypertensive treatment alone could prevent 89,000 premature deaths in the United States annually 15
  • The combined drug and medical costs for the most compliant diabetes patients average almost 50% below the cost for the least-compliant group 6
  • Each additional dollar spent on diabetes medication is estimated to save $7 in medical costs 8
  • For diabetes, hypercholesterolemia and hypertension, hospitalization rates were significantly lower for patients with high medication adherence 8
  • Only one-third of all patients actually take their medications as directed 6
  • Half of all prescriptions fail to have the proper effect because of failure to take the drug or follow instructions 9
  • Twenty percent (20%) of prescriptions are never filled 9
  • Of the 3 billion medication prescriptions issued each year in the US, 12% are never picked up by the patient and 40% are not taken correctly 16
  • Only about 8% of U.S. consumers are aware of their own non-compliance 13
  • Typical non-adherent patients visiting HCPs three additional times per year have increased treatment costs of $2,000 per year over those following prescribing instructions 14

Chronic Conditions:

  • 133M people have at least one chronic disease10
  • Represent 75% of total health care expenditures 2
  • More than 45% of non-institutionalized Americans has one or more chronic conditions11
  • Account for:
    • 69% of hospital admissions
    • 80% of hospital days
    • 55% of emergency room visits
  • 75% of people with chronic conditions are under age 7,5,10

FOOTNOTES

1 IMS Special Strategy Supplement: Reviving the Primary Care Market, July 17, 2008 IMS Health
2 Thomas Bodenheimer, MD, and Alicia Fernandez, MD, "High and Rising Health Care Costs. Part 4: Can Costs Be Controlled While Preserving Quality?" Annals of Internal Medicine, 143:1 (2005), pages 26-31. This cost estimate is for direct healthcare costs only; it does not include the indirect costs of lost productivity for the person with a chronic condition or that person's caregivers.
3 "10th Annual Survey of Large Employers," Watson Wyatt Worldwide and National Business Group on Health, 2005.
4 World Health Organization (2003), "Adherence to Long-Term Therapies: Evidence for Action," page 35
5 Osterberg, L. and Blaschke, T., "Adherence to Medication," N. England J Med, 2005; 353:487-97
6 "Pharmaceutical Patient Adherence and Disease Management: Program Development, Management and Improvement," (2006) Cutting Edge Information
7 Tom Starner, Human Resource Executive, May 2, 2006, "The Price of Non-Compliance," http://www.hreonline.com/HRE/story.jsp?storyId=5059249
8 Michael C. Sokol, MD, MS; Kimberly A. McGuigan, PhD., Robert R. Verbrugge, PhD and Robert S. Epstein, MD, MS, "Prospective Cohort Observation," Med Care 2005;43: 521-530
9 Koroneos, George, "Hard of (Ad)hering", Pharmaceutical Executive, August 1, 2008
10 Wu S, Green A., Projection of Chronic Illness and Cost Inflation, RAND Corporation, October 2000
11 Hoffman, D. Rice, and H-Y. Sung, "Persons with Chronic Conditions: Their Prevalence and Costs," Journal of the American Medical Association 276, no. 18 (1996): 1473-1479.
12 Michael E. Porter & Elizabeth Olmsted Teisberg, Redefining Health Care: Creating Value-Based Competition on Results, Harvard Business School Press; 2006
13 Boehm, Elizabeth W., Brown, Eric G. and McEnroe, Will, (April 14, 2006) Rx Adherence Hits The Ignorance Wall, Why Pharma And Payers Must Put More Muscle Behind Drug Compliance, Forrester Research.
14 Medication Compliance-Adherence-Persistence Digest, (2003) American Pharmacists Association
15 "Thinking Outside the Pillbox: Medication Adherence as a Priority for Health Care Reform," David M. Cutler, Ph.D., and Wendy Everett, Sc.D., Engl J Med (362):1553-1555, April 29, 2010
16 Jean Steckler, A Review of US REMS Regulation and Compliance" February, 010,
http://ireminder.com/research/white-papers

Real Life Perspective of Adherence and Compliance

In a perfect world all patients would adhere to their treatment regimens.

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But the world is far from perfect."