WASHINGTON, D.C., October 27, 2009 – A diverse group of health care and consumer organizations released five policy recommendations this week that are designed to promote better medication adherence and improved health outcomes for patients.
The group, which includes the American College of Cardiology, GlaxoSmithKline, the National Association of Chain Drug Stores, the National Consumers League and the Pharmaceutical Research and Manufacturers of America, focused their recommendations on the areas of quality improvement, care coordination, health information technology, patient/provider education and engagement, and health services research.
Although some of the recommendations have been the subject of discussion during the ongoing health care reform debate, and in fact have been reflected in some of the proposals under consideration, the recommendations are being released with an eye toward an ongoing and consistent commitment to improving health care - and health outcomes - in America.
According to a 2005 study published in the New England Journal of Medicine, an estimated one-third to one-half of all patients in the United States do not take their medications as prescribed. The impact of this non-adherence is costly in terms of both quality of care and medical expenses. In fact, recent research including work by the New England Healthcare Institute (NEHI) and a 2004 study published in Medical Care suggested that costs resulting from non-adherence may be as high as $300 billion annually.
"Not only is poor medication adherence costly, but it also can be dangerous," said Sally Greenberg, Executive Director of National Consumers League. "Because patients don't take their medications for a variety of reasons, including side effects, misconceptions or fears about the medication, trouble with dosing, and costs such as co-pays, we need to employ a multitude of strategies to improve adherence. Our efforts are focused on identifying key opportunities to reduce barriers that keep patients from adhering to their medications."
The five recommendations were constructed, refined and finalized following a July conference with more than 40 medication adherence experts, including providers, patients, health plans, employers, and researchers. The dialogue was informed by research by the RAND Corporation, which conducted a review of the literature on medication adherence to provide an evidence-base for the discussions, and by Avalere Health, which described lessons learned from here-and-now programs to improve medication adherence.
Walid Gellad, M.D., the lead RAND researcher on this review noted that, "Poor medication adherence is an enormous public health problem. Finding solutions to this problem should be part of health reform discussions now and in the future."
Each of the recommendations is supported by specific action items to help guide its implementation. To see the full recommendations, please click here:
Quality Improvement – National quality improvement strategies should explicitly recognize medication adherence and appropriate medication use as critical components to improve health care quality and clinical outcomes.
Care Coordination – Proposals aimed at improving care coordination must recognize the important role that medications play in treating and managing illnesses.
Health Information Technology – Health information technology must improve the flow of timely and complete information between patients and providers, and enable providers and payers to identify and address gaps in patients' medication use.
Patient/Provider Education and Engagement – Strategies to improve medication adherence must fully engage patients, and patient-centered care must involve strategies to help them better understand their conditions and treatments. These efforts also must support providers in effectively communicating the importance of following treatment plans, and in providing medication support services to patients and caregivers.
Health Services Research – There is a need for additional research on medication adherence, including a focus on the effectiveness of a wider range of interventions to improve adherence, as well as an analysis of the diverse factors, behaviors, costs and consequences related to poor adherence.
"Medical adherence is a problem that should unite all providers, elected officials, pharmacists, insurers and pharmaceutical companies," said Jack Lewin, CEO of the American College of Cardiology. "Fifty percent of patients with heart disease are not taking their potentially life-saving medications, but it is our hope that recommendations like these will go a long way toward addressing this serious problem."
Other organizations who are seeking to learn more or to endorse these recommendations should contact Colette Desmarais at Colette@mvc-dc.com.
About the Participating Organizations
The American College of Cardiology is leading the way to optimal cardiovascular care and disease prevention. The College is a 37,000-member nonprofit medical society and bestows the credential Fellow of the American College of Cardiology upon physicians who meet its stringent qualifications. The College is a leader in the formulation of health policy, standards and guidelines, and is a staunch supporter of cardiovascular research. The College provides professional education and operates national registries for the measurement and improvement of quality care. More information about the association is available online at www.acc.org.
GlaxoSmithKline – one of the world's leading research-based pharmaceutical and healthcare companies – is committed to improving the quality of human life by enabling people to do more, feel better and live longer. For further information please visit www.gsk.com
The National Association of Chain Drug Stores (NACDS) represents 154 traditional drug stores, supermarkets, and mass merchants with pharmacies – from regional chains with four stores to national companies. NACDS members also include more than 900 pharmacy and front-end suppliers, and over 70 international members from 24 countries. Chains operate 37,000 pharmacies, and employ more than 2.5 million employees, including 118,000 full-time pharmacists. They fill more than 2.5 billion prescriptions annually, which is more than 72 percent of annual prescriptions in the United States. The total economic impact of all retail stores with pharmacies transcends their $815 billion in annual sales. Every $1 spent in these stores creates a ripple effect of $3.82 in other industries, for a total economic impact of $3.11 trillion, equal to 26 percent of GDP. For more information about NACDS, visit www.NACDS.org.
The National Consumers League is a private, nonprofit advocacy group representing consumers on marketplace and workplace issues. Its mission is to protect and promote social and economic justice for consumers and workers in the United States and abroad. NCL, the nation's oldest consumer organization, provides government, businesses, and other organizations with the consumer's perspective on concerns including child labor, privacy, food safety, and medication information. For more information visit www.nclnet.org.
The Pharmaceutical Research and Manufacturers of America (PhRMA) represents the country's leading pharmaceutical research and biotechnology companies, which are devoted to inventing medicines that allow patients to live longer, healthier, and more productive lives. PhRMA companies are leading the way in the search for new cures. PhRMA members alone invested an estimated $50.3 billion in 2008 in discovering and developing new medicines. Industry-wide research and investment reached a record $65.2 billion in 2008. Additional information can be found at www.phrma.org.