Scrutinizing Adherence Must Not Be Short Sighted

August 11, 2014

Considering how critical taking medications as prescribed is to managing chronic diseases effectively, it should be no surprise that improving patient adherence to medicines can deliver great value. This truth makes the conclusions of an article in Health Affairs’ about declining medication adherence rates in Medicare Part D particularly troubling.

Adding the option for Medicare beneficiaries to purchase prescription drug coverage, Part D, improved the affordability of medications for millions of beneficiaries. Researchers analyzing affordability under Medicare Part D over time found that the improvements in affordability are eroding and the most vulnerable beneficiaries are feeling the effects. Specifically, among elderly beneficiaries with more than four chronic conditions – over half of all Medicare beneficiaries – medication non-adherence rates rose to 17 percent in 2011. Perhaps even more disturbing, among the sickest elderly, the percentage forgoing basic needs to purchase medicines rose to 10.2 percent in 2011. Targeted efforts may be needed to protect Medicare’s most vulnerable beneficiaries and continue the gains Part D has delivered in access to medicines and improved medication adherence.

Overall, Medicare Part D continues to enjoy high satisfaction ratings among beneficiaries. In fact, a recent Medicare Today survey showed that 86 percent of Medicare beneficiaries are satisfied with their Medicare Part D coverage and find co-pays to be affordable. And further, a recent study published in the American Journal of Managed Care focused specifically on the economic impact of Medicare Part D on congestive heart failure found more evidence of the positive impact the Medicare population is experiencing.

Representing 14 percent of the Medicare population, more than 3.5 million Part D enrollees were diagnosed with CHF in 2010.The study found that improved medication adherence associated with expansion of drug coverage under Part D led to nearly $2.6 billion in savings on medical expenditures, of which over $2.3 billion was savings to Medicare. Further improvements in adherence could potentially save Medicare another $1.9 billion annually, generating upwards of $22.4 billion in federal savings over 10 years.

These savings would not be so significant without a dynamic arsenal of healthcare solutions aimed at sustainably improving health outcomes and healthcare bottom lines. Part D plays an important role in better managing costly chronic diseases, without it Medicare beneficiaries, especially those struggling with multiple chronic conditions, would face far greater, and much more financially taxing, challenges. In light of the many uphill battles facing policymakers in the healthcare arena, it seems rather shortsighted to rush to undercut a program that is providing millions with prescriptions that are not only improving and saving lives but also save billions of dollars.