Should payers incentivize pharmacies to blister-package chronic medications?

Medication nonadherence is prevalent among patients taking acute and/or chronic medications. It has been associated with poorer health outcomes, increased mortality, and higher costs for payers and the health care system. Numerous factors contribute to medication nonadherence, with forgetfulness being the primary reason. Payers have a vested interest in improving patient adherence to medications to mitigate overall health care costs by enhancing disease management, and they typically offer programs and initiatives aimed at improving medication adherence. One intervention that has had success in improving medication adherence and patient outcomes across a variety of disease states is putting patients' medications in blister packs. Although there is decades' worth of evidence demonstrating the success of blister packaging, utilization outside of the long-term care setting in the US is limited, likely due to the fragmentation of the health care system. Even though putting medications in blister packs has the potential to improve outcomes, pharmacies are the institutions that would have to implement this initiative while not seeing the financial savings from the reduced health care costs. Although it may improve their patients' outcomes, they would not be capturing the cost savings required to implement a potential new workflow and/or offset additive costs. Therefore, payers should consider incentivizing pharmacies to put medications in blister packs. Because payers would realize cost savings from the reduction in health care costs, they could reinvest some of that money toward blister packaging at their pharmacies and/or provide preferred contracting and network status for independent pharmacies that blister-package medications to help improve their population's health.