For people who don’t have prescription drug plans, drug costs can be a significant burden. Some people even stop taking their medications. According to a paper published in the Journal of General Internal Medicine, between 20 to 30 percent of prescriptions are never filled.
Research is showing the clinical and economic benefits of expanding programs that reduce the cost of drugs. If that continues, insurers may be able to expand the number of drugs they cover at reduced costs or for free.
“Certainly, very high costs can keep people from taking a drug regularly,” Ed Pezalla, M.D. M.P.H., national medical director at Aetna, said. “Lowering copays can help, but that alone doesn’t fix the complex problem of medication adherence.”
For example, Aetna worked with Brigham and Women’s Hospital and Harvard Medical School to give free heart drugs to patients who had just suffered heart attacks. However, this effort only raised patient drug adherence from 42 percent to 49 percent.
“Reducing prescription drug costs only raised patient adherence from 42 percent to 49 percent.”
“The best news is we did cut subsequent heart attacks and some admissions and procedures,” said Pezalla. “The cost of the medication was more than offset by the savings from patients doing better. But we could not break that 50 percent mark, even with free drugs.” And this was after people had a heart attack.
If cheap or free drugs aren’t the whole answer – what is?
Insurers already have programs in place to help people stay on track with medication compliance. For example, Aetna provides support to those who need high-cost specialty drugs to treat serious conditions. The insurer helps people understand how to take the drugs and that they are taking the drug as prescribed. They can also help people deal with any side effects.
Electronic health records tied to programs that follow up with patients also may be part of the solution. As the health care system adopts new models such as accountable care organizations and patient centered medical homes, more opportunities will open up to help people stay on track with their medications.