There are a variety of ways to encourage patients to get better engaged in their care to make their treatments more effective. But maybe efforts should increase the focus on a core form of engagement — medication adherence.
A growing body of research indicates that if more patients took their drugs as directed, everyone involved would be better off. Increasingly, members of the industry are viewing the improvement of medication adherence as a "win-win-win" for providers, payers and drug companies, says Tom Hubbard, vice president of policy research for NEHI, a policy research institute. Patients would be healthier, costs would drop and more drugs would be sold, Hubbard says.
The idea is that if chronically ill patients with multiple conditions did a better job of taking their medicine, they would be less likely to need care from a physician or other provider.
The goal of improving adherence is not a new one, and is a strategy included in patient engagement approaches such as the American Hospital Association's "Engaging Health Care Users: A Framework for Healthy Individuals and Communities."
But a turning point in the perception of whether that theory holds may have come in November when the Congressional Budget Office changed its stance to one that acknowledges there are benefits to better medication adherence. After reviewing recent research, the CBO estimated that a 1 percent increase in the percentage of Medicare Part D prescriptions filled would reduce Medicare services spending by roughly 0.2 percent.
That potential for savings is drawing attention in Washington. The Medicare Payment Advisory Commission this year said it would be studying the issue more closely, while members of Congress also would like to know more. There is real interest in Congress despite how polarized it has been on the issue of health care, Hubbard says.
With that in mind, NEHI just issued a report outlining six priorities for regulatory or legislative moves in that regard.
NEHI recommends such things as promoting the sharing of best practices and lessons learned from pilots, and the large-scale support of techniques shown to be effective.
There's also some opportunity and interest on the Hill in revamping and expanding a related Medicare Part D service known as Medication Therapy Management services.
Even though Congress has not done much of anything regarding health care this year, having an association with the words "reduced" and "costs" may spur some initial legislative action to improve medication adherence. But it's a big unknown as to when and how that might occur.