Successful management of a chronic disease often comes down to a crucial factor: patients taking their medications as prescribed. But it can be tough to stick to a routine, especially one that includes multiple prescriptions. Unfortunately, medication non-adherence can lead to health complications for patients, and higher readmissions and lower quality scores for hospitals.
On November 14, World Diabetes Day shines a spotlight on the 589 million people around the world managing the disease every day, with a focus on care strategies that drive better outcomes. The American Diabetes Association estimates the annual cost of diabetes care is over $400 million.
Leading health systems are shifting their focus upstream by removing barriers that lead to non-adherence to prevent the serious complications that flow downstream:
The everyday hurdles patients face—like high prescription costs and prior authorization (PA) delays—stack up quickly, leading to missed medications and worsening health. In the U.S., non-adherence accounts for up to 50% of treatment failures, around 125,000 deaths, up to 25% of hospitalizations, and costs the healthcare system an estimated $290 billion.
Out-of-pocket expenses are a major factor in whether patients pick up their medications or abandon them at the pharmacy. Three in 10 adults don’t take medications as prescribed because they can’t afford them.
Humana and DrFirst partnered on a program designed to close critical gaps in care for patients with chronic conditions like diabetes and cardiovascular disease.
Fierce Healthcare detailed how Humana is using the DrFirst prescription orchestration platform to close gaps in care by recommending new prescriptions for high-risk patients. Providers receive the requests in workflow and can generate the prescription with a single click or note why it’s not an appropriate choice for the patient.
“We’re not just flagging care opportunities—we’re making sure they get to providers in a way that’s timely and easy to act on,” said Bethanie Stein, PharmD, President, Pharmacy at Humana. “By reaching providers in their workflow, we’re freeing them to focus on patient care, which in turn can help address gaps in care, promote quality and lead to better health outcomes.”
These integrated solutions:
For chronic conditions like diabetes and others, focusing on these critical strategies leads to a more predictable path to better outcomes and lower costs.
Memorial Healthcare System has launched a comprehensive medication management initiative to enhance adherence and improve health outcomes for patients with diabetes.
A recent story in First Report Managed Care details how the health system uses prescription fill data from DrFirst to proactively identify patients at risk and engage them through telehealth and digital tools to support timely clinical interventions.
“By developing programs that serve high-risk patients, we shift from reactive to proactive interdisciplinary care … driving meaningful outcomes and building a healthier community,” said Dovena Lazaridis, PharmD, Director of Ambulatory and Population Health Pharmacy Services.
“Diabetes remains one of the most challenging and resource-intensive conditions we manage,” she added. “By using timely, comprehensive medication history data, our care teams can proactively identify adherence barriers, intervene early, and help prevent complications that often result in hospitalizations.”
Want to see the real cost of non-adherence and how technology is being used to fix it?
Download our infographic, “Stop the Downstream Damage of Medication Non-Adherence” to get all the insights.