The Three-Hundred Billion Dollar Problem

Medication adherence is arguably one of the most important contributors toward improved patient health. In a HITLAB seminar featuring Information Mediary Corp. (IMC), panelist John Musaus, Founder & Executive Director of Adherence Measurement Institute, defined medication adherence as the process by which patients take their medications as prescribed. Musaus further explained that adherence can be broken up into three different elements: initiation, implementation, and persistence.

Panelist Dr. Frank R. Lichtenberg, Professor of Business at Columbia University, illustrated the importance of evaluating both the consequences of adherence and non-adherence through his recent completed study of diabetic patients in Denmark. The study found that fewer than half of the diabetic patients were consuming the appropriate amount of medication. Through prospective observations during the follow-up period, patients who consumed the appropriate amount of medication and were adherent to their treatment regimen had a life expectancy of two and half years longer than those who were not adherent. As Dr. Litchtenberg noted, the relationship between adherence and increased longevity is quite dramatic.

Panelist John Kimmet, Head of Strategic Planning & Decision Analysis at Celgene, shared a more personal aspect on the importance in medical adherence when he revealed how being non-adherent negatively affected a close family member. Kimmet believes that there are several different approaches to take when trying to implement medical adherence. However, the key is to try to understand what can be done to improve the outcomes. From a practical standpoint, technology, such as text-messaging reminders are a great way to start. Panelist Sloane Salzburg, Executive Director of Prescriptions for a Healthy America, added that in addition to reminders, digital health tools can allow electronic prior authorization capabilities, which will help patients get their prescriptions quicker. Kimmet expressed that it’s really a combination of things that can ultimately improve adherence and outcomes. Specifically, the combination of focusing on simplicity and the viewpoint of patients.

What does the future of medical adherence look like? Kimmet answered by saying that there is no perfect solution, but ultimately it is the continued progress in this area that will help to benefit patients in the future. It is crucial to address the real problems that exist, especially the ones that tech can solve. Musaus believes that the future involves the adoption of technologies such as the monitoring of patients at home, as traditional office work is now done remotely. Dr. Lichtenberg follows by quoting former Surgeon General Everett Koop in saying “medicines don’t help people, if they don’t take them.” He thinks that a simple implementation of a 90-day mail supply order can increase adherence, and ultimately increase the population’s health. Salzburge then concluded the seminar by saying “medication adherence or non-adherence is a three hundred-billion-dollar problem. Adherence technologies are the future. “

Ansley Bowen

Ansley Bowen

Ansley Bowen is a graduate student at Tulane University’s School of Public Health and Tropical Medicine. Ansley is working under HITLAB’s Developing Emerging Leaders in Public Health Initiative with a focus on integrating innovation into healthcare and public health.

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