Medication Adherence in the USA

Poor Medication Adherence – the $300 billion Problem

An overlooked healthcare problem world-wide is the severe lack of medication adherence, though a problem that is gaining attention as governments focus on healthcare costs and improving outcomes.

The US Situation:

  • Half of all patients do not take their medications as prescribed [1]
  • More than 1 in 5 new prescriptions go unfilled [2]
  • Adherence is lowest among patients with chronic illnesses [3]
  • At least 125,000 Americans die annually due to poor medication adherence [4]
  • As adherence declines, emergency room visits increase by 17% and hospital stays rise 10% among patients with diabetes, asthma, or gastric acid disorder [5]
  • Poor medication adherence results in 33% to 69% of medication-related hospital admissions in the United States, at a cost of roughly $100 billion per year [1]
  • NEHI estimates that total potential savings from adherence and related disease management could be $290 billion annually — 13% of health spending [6]
  • In Parkinson’s Disease, adjusting for confounders including comorbidity burden, nonadherence was associated with a $3,451 yearly increase in medical costs [7]
  • The global pharmaceutical industry loses an estimated $564 billion annually due to medication non-adherence. The estimate for the US pharmaceutical industry is $188 billion. [8]

References:

[1] Osterberg L, Blaschke T. “Adherence to Medication.” New Engl.J. Med., Aug 4, 2005; 353(5): 487-97.

[2] Fischer MA, Choudhry NK, et al. “Trouble Getting Started: Predictors of Primary Medication Nonadherence.Am. J. of Med., 2011 November; 124(11): 1081.e9 – 1081.e22; See also, Fischer MA, Stedman MR, Lii J, et al. “Primary Medication Non-Adherence: Analysis of 195,930 Electronic Prescriptions.” J. Gen. Intern. Med., 2010 April; 25(4): 284–290.

[3] Sokol MC, McGuigan KA, Verbrugge RR, Epstein RS. “Impact of Medication Adherence on Hospitalization Risk and Healthcare Cost.” Med Care. Jun 2005 ;43(6):521-30.

[4] McCarthy R, “The price you pay for the drug not taken.Bus Health. 1998;16:27-28,30,32-33.

[5] Goldman D, “Pharmacy Benefits and the Use of Drugs by the Chronically Ill.”, J. of the Amer. Med. Ass’n, 19 May 2004.