Medication Non Compliance

Jul 29, 2014

Non compliance, also referred to as non adherence, refers to how a patient follows prescribed directions for their medication. Adherence is defined as patients who take the proper medication at the right dosage level at the proper time each day for the duration of their prescription. Plan members who do not follow these directions are considered non compliant or non adherent.

The World Health Organization estimates adherence within long-term therapy for chronic illnesses to be around 50%. The consequences are significant for both plan members and plan sponsors. Plan members might experience reduced quality of life and potentially shorter life spans. Plan sponsors are on the hook for the costs of suboptimal therapy or results, costs of an under-treated disease, potential additional therapeutic costs due to worsening of the initial disease, productivity loss, increased absenteeism and increased disability claims.

In Canada, it is estimated up to half of patients do not take their medications as directed and many do not even fill their prescriptions in the first place. A 2011 antidepressant adherence study conducted by Green Shield Canada showed startling non adherence levels between 52% and 58%. The costs are equally disturbing with non adherent plan members costing plans 3.3 times more on average than other plan members ($2,200 versus $650). In addition, 40% of high blood pressure and cholesterol claimants were non adherent costing plans 3.3 and 3.5 times more respectively.

Plan sponsors should consider the long term impact as 20% of claimants account for 75% of drug costs. The top drug therapies on all benefits plans are dominated by chronic illness. As the Canadian workforce ages, chronic illness incidence rates will increase. Having a strategy to combat non adherence can have a profound impact on both employee health and company benefit costs.

Perhaps the time is now to increase awareness to this very real problem!

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