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Does good medication adherence really save payers money?

Bruce C Stuart1, Mingliang Dai, Jing Xu

  • 1*Department of Pharmaceutical Health Service Research, The Peter Lamy Center on Drug Therapy and Aging, University of Maryland School of Pharmacy †Division of Gerontology, University of Maryland School of Medicine ‡Department of Pharmaceutical Health Services Research, University of Maryland School of Pharmacy, Baltimore, MD §Department of Policy Research, PhRMA, Washington, DC.

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Summary
This summary is machine-generated.

Controlling for healthy adherer bias significantly reduces estimated medical cost savings and additional drug spending linked to medication adherence in Medicare beneficiaries. Further research is needed.

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Area of Science:

  • Health economics
  • Pharmacoepidemiology
  • Health services research

Background:

  • Medication adherence can reduce healthcare costs, but analyses may be biased by unobserved factors.
  • Previous cost-offset calculations might be incomplete due to healthy adherer bias (HAB).

Purpose of the Study:

  • To assess the impact of controlling for HAB on estimated medical cost offsets and additional drug spending associated with medication adherence.
  • To determine if HAB materially affects economic evaluations of adherence interventions.

Main Methods:

  • Analysis of Medicare Current Beneficiary Survey data (claims and survey) for 1273 beneficiaries from 2006-2009.
  • Comparison of regression models with and without survey-based variables to control for HAB.
  • Measurement of medical and drug costs related to adherence to oral antidiabetic drugs, ACE inhibitors/ARBs, and statins.

Main Results:

  • Controlling for HAB consistently reduced estimated medical cost savings from better adherence.
  • HAB-controlled models showed lower estimates of additional adherence-related drug spending (26% and 14% reductions).
  • For ACE inhibitors/ARBs, medical cost offsets decreased from $6389 to $4920 per person after controlling for HAB.

Conclusions:

  • The economic benefits of improving medication adherence may be overestimated without accounting for HAB.
  • Findings support healthcare payers taking action to enhance medication adherence in patients with chronic diseases.
  • Further research with larger samples and diverse disease states is recommended to validate these findings.