Date post: | 27-May-2015 |
Category: |
Health & Medicine |
Upload: | phrma-pharmaceutical-research-and-manufacturers-of-america |
View: | 2,881 times |
Download: | 5 times |
Medicines Play a Key Role in Improving Health While Reducing Avoidable Costs
Pharmaceutical Research and Manufacturers of America
Overview
Poor medication adherence = higher overall healthcare costsResearch shows that treatment gaps and lack of adherence to physician-prescribed medications lead to higher spending on otherwise avoidable medical care.
Proper medication adherence saves patients money on healthcarePotential cost savings from appropriate use of medicines can be significant, especially for the growing number of Americans with chronic health conditions.
Prescription medicines play a key role in:• Maintaining health• Reducing mortality• Preventing emergency room visits/hospitalizations• Improving worker productivity
Proper medication adherence lowers overall healthcare costs due to offsets in related costs (i.e., hospitalization, emergency care visits)
Pharmaceutical Research and Manufacturers of America
How does access and adherence to medicines affect health outcomes and medical costs?
Medicare Part D Improves Access to Medicines & Lowers Costs
Medicare Part D has increased access to medicines for patients while lowering out-of-pocket costs.
For seniors who
previously had
limited Rx
coverage,
spending declined
by $1,200 for non-
drug medical
services in 2006
and 2007
Part D coverage has led to spending reductions in Medicare for hospitalsand nursing homes.
Research suggests that
more reductions in
medical savings could
come as the Part D
coverage gap is filled
Pharmaceutical Research and Manufacturers of America
Read More: J.M. McWilliams et al. “Implementation of Medicare Part D and Nondrug Medical Spending for Elderly Adults With Limited Prior Drug Coverage.” Journal of the American Medical Association, July 27, 2011.
Prescription Medication Use Reduces Hospitalization Costs
According to a 2009 study, adherent use of prescription medicines significantly reduced Medicare spending for inpatient hospitalizations.
Each additional
prescription filled reduced
inpatient costs by $104, or
about 5% on average.
Study authors say their finding “suggests that drugs are not only cost-effective but actually save money for Medicare beneficiaries.”
The average cost of a
prescription medicine in the
study was $47 – that’s an
overall net savings of $57.
Pharmaceutical Research and Manufacturers of America
Read More: B.C. Stuart et al. “Assessing the Impact of Drug Use on Hospital Costs.” Health Services Research, February 2009.
Key Medication Adherence Facts:• Each additional prescription drug fill reduces hospital
costs by about 0.5% (when measured at the mean level of Medicare payments in 2000)
• The average cost of beneficiaries experiencing at least one inpatient hospitalization in 2000 was $10,425 per person hospitalized
Key Access to Medicines Facts:• Medicare beneficiaries with little to no prior drug benefits
increased their use of medicines after enrolling in Part D• Part D enrollees in this category increased monthly drug
spending by $27, but decreased overall monthly medical spending by $46
Access to Medicines Results in Significant Medicare Savings
.A recent Harvard study in JAMA found that Part D saves Medicare about $1,200 per year in hospital, nursing home and
other costs for each senior who previously lacked comprehensive prescription drug coverage.
Medicare Part D implementation
resulted in nearly 11 million
seniors gaining comprehensive
prescription drug coverage.
According to other experts, this finding led to overall savings to Medicare of $13.4 billion in 2007, the first full year of Part D. This represents more than one quarter of Part D’s total cost
during that time.
Pharmaceutical Research and Manufacturers of America
Read More: C.C. Afendulis and M.E. Chernew. “State-Level Impacts of Medicare Part D.” American Journal of Managed Care, October 2011 Supplement. http://jama.jamanetwork.com/article.aspx?articleid=1104150
Medication Adherence Lowers Overall Patient Costs
Even though patients who adhere to their medication schedule spend more on prescription medicines, additional spending is more than offset by substantial reductions in spending on other medical care.
Every additional dollar
spent on medicines
generated between $3
and $10 in savings on
medical care – a 200%-
900% return on
investment.
Adherence can lead to significant reductions in emergency department visits and inpatient hospital days for patients with four chronic conditions.*
Every additional dollar
spent on medicines by
seniors generated between
$4 and $14 in savings on
medical care, a 300%-
1300% return on
investment.
* Congestive heart failure, hypertension, diabetes and dyslipidemia
Pharmaceutical Research and Manufacturers of America
Read More: M.C. Roebuck et al. “Medical Adherence Leads to Lower Health Care Use And Costs Despite Increased Drug Spending.” Health Affairs, January 2011.
Pharmaceutical Research and Manufacturers of America
Highly adherent patients with hypertension have substantially lower total healthcare costs than non-adherent patients, and costs increase as adherence decreases.
Total costs for
highly adherent
patients were
$1,246 lower over
a one-year span
than total costs of
care for patients in
the lowest
adherence
category.
Medication Adherence Leads to Lower Overall Healthcare Costs
How does adherence lower costs for hypertension?
Read More: D.G. Pittman et al. “Antihypertensive Medication Adherence and Subsequent Healthcare Utilization and Costs.” American Journal of Managed Care, August 2010.
Medication Adherence Leads to Lower Overall Healthcare Costs
Pharmaceutical Research and Manufacturers of America
Commercially insured patients with high rates of adherence to statins had significantly lower healthcare costs and lower risks of cardiovascular disease.
According to a
Medco Health study,
increasing
adherence to statins
has the potential to
save over $3 billion
annually on health
care costs.
How does adherence lower costs for cardiovascular disease?
Read More: D.G. Pittman et al. “Adherence to Statins, Subsequent Healthcare Costs, and Cardiovascular Hospitalizations.” American Journal of Cardiology, June 2011.
Medication Adherence Leads to Lower Overall Healthcare Costs
Pharmaceutical Research and Manufacturers of America
For diabetes patients, a high level of medication adherence is associated with lower disease-related medical costs.
Researchers
estimate increased
patient adherence
would yield a return
on investment of
over 4:1 to diabetes
patients
How does adherence lower costs for diabetes?
Read More: M.C. Sokol et al. “Impact of Medication Adherence on Hospitalization Risk and Healthcare Cost.” Medical Care, June 2005.
Cost of Diabetes
Medication Adherence Leads to Lower Overall Healthcare Costs
Pharmaceutical Research and Manufacturers of America
Proper use of diabetes medicines significantly reduces the risk of disease-related complications.
Adherent diabetes
patients were half
as likely to have a
heart attack,
undergo an
amputation or
treatment for an
ulcer, or experience
an adverse renal
event potentially
leading to kidney
cancer.
In 2011, better adherence to diabetes medicines resulted in significantly lower Medicare spending on hospital and physician services, and these savings exceeded the estimated cost of the drugs.
Read More: T.B. Gibson et al. “Cost-Sharing, Adherence, and Health Outcomes in Patients with Diabetes.” American Journal of Managed Care, August 2010.
Poor Adherence Leads to Undesirable Outcomes
Pharmaceutical Research and Manufacturers of America
Proper adherence to osteoporosis medicines greatly reduces medical costs, particularly hospitalization and long-term care costs. Similar results were seen for Medicare Advantage enrollees with low levels of adherence.
Low adherence to
osteoporosis medicines
was associated with 12%
higher all-cause medical
costs and 59% more all-
cause hospitalizations.
Medicare Advantage
patients with low medicine
adherence had 18% higher
medical costs and 34%
more hospitalizations than
adherent patients.
Key Osteoporosis Facts:• Osteoporosis fractures alone cost an estimated
$19 billion in 2005, and are projected to cost $25 billion by 2025
• Highly compliant patients cut their risk of fracture by 25%
• Patients with highest rates of adherence spent $1,273 less on total medical costs on average
How does adherence lower costs for osteoporosis?
Read More: R. Halpern et al. “The Association of Adherence to Osteoporosis Therapies with Fracture, All-Cause Medical Costs, and All-Cause Hospitalization: A Retrospective Claims Analysis of Female Health Plan Enrollees with Osteoporosis.” Journal of Managed Care Pharmacy, January/February 2011.
Capping Prescription Coverage Has Little Effect on Total Health Care Costs
Pharmaceutical Research and Manufacturers of America
Seniors with a $1,000 benefit cap under Medicare+Choice were less likely to use medicines appropriately and experienced unfavorable clinical outcomes, including death, according to a NEJM study.
Use of medicines to treat
hypertension, high
cholesterol and diabetes
was 15%, 27% and 21%
lower, among those with
capped coverage.
Savings from lower use of medicines were almost completely offset by increases in hospitalization and emergency care costs.
Total medical costs
were only 1% lower
than those not
subject to the cap.
Read More: J. Hsu et al. “Unintended Consequences of Caps on Medicare Drug Benefits.” New England Journal of Medicine, June 1, 2006.
Appendix: Sources
Slide 4
J.M. McWilliams et al. “Implementation of Medicare Part D and Nondrug Medical Spending for Elderly Adults With Limited Prior Drug Coverage.” Journal of the American Medical Association, July 27, 2011.
Slide 5
B.C. Stuart et al. “Assessing the Impact of Drug Use on Hospital Costs.” Health Services Research, February 2009.
Slide 6
C.C. Afendulis and M.E. Chernew. “State-Level Impacts of Medicare Part D.” American Journal of Managed Care, October 2011 Supplement.
Slide 7
M.C. Roebuck et al. “Medical Adherence Leads to Lower Health Care Use And Costs Despite Increased Drug Spending.” Health Affairs, January 2011.
Slide 8
J. Hsu et al. “Unintended Consequences of Caps on Medicare Drug Benefits.” New England Journal of Medicine, June 1, 2006.
Slide 9
D.G. Pittman et al. “Antihypertensive Medication Adherence and Subsequent Healthcare Utilization and Costs.” American Journal of Managed Care, August 2010.
Slide 10
D.G. Pittman et al. “Adherence to Statins, Subsequent Healthcare Costs, and Cardiovascular Hospitalizations.” American Journal of Cardiology, June 2011.
Slide 11
M.C. Sokol et al. “Impact of Medication Adherence on Hospitalization Risk and Healthcare Cost.” Medical Care, June 2005.
Slide 12
T.B. Gibson et al. “Cost-Sharing, Adherence, and Health Outcomes in Patients with Diabetes.” American Journal of Managed Care, August 2010.
Slide 13
R. Halpern et al. “The Association of Adherence to Osteoporosis Therapies with Fracture, All-Cause Medical Costs, and
All-Cause Hospitalization: A Retrospective Claims Analysis of Female Health Plan Enrollees with Osteoporosis.” Journal of
Managed Care Pharmacy, January/February 2011.
Pharmaceutical Research and Manufacturers of America