The African proverb, “It takes a village to raise a child,” suggests the collective effort needed to raise a happy, healthy child. Yet, it takes a village to make a meaningful impact on a wide variety of issues—including medication adherence.
Non-adherence can occur for a myriad of reasons. Socio-economic factors such as income, transportation difficulties and health illiteracy are just some examples. One Surescripts survey found that half of patients reported not taking a medication due to cost, and 3 in 10 had not taken a prescription because it took too long to fill. Rising chronic conditions and COVID-19’s health and financial ramifications are other trends that could exasperate non-adherence.
When patients are caught off guard by prescription costs or prior authorization requirements, they lose trust and satisfaction in their healthcare experience. If sticker shock or administrative delays are severe, they may abandon treatment, creating worse outcomes and higher costs in the long run. Those costs and consequences can be as routine as restocking a prescription or as extreme as hospital readmission, but they all add up to a serious problem for healthcare organizations. In fact, annually $105 billion of preventable healthcare costs in the U.S. have been attributed to non-adherence.
Until recently, healthcare providers have lacked the tools to easily choose prescription options that they're confident patients can access, afford and adhere to. What should be a simple process—getting patients started on an optimal medication—has incurred heavy administrative burdens across the entire healthcare system, from prescription rework to inefficient prior authorization processes.
Providers, payers and pharmacy benefit managers (PBMs) each play a role in helping ensure patients have access to the most affordable and effective medications. Unfortunately, these groups often operate in data silos, leaving patients with expensive medications that force many patients to ration their medications or leave them at the counter.
Providers, payers and pharmacies can work together to better enable technology to make this information exchange a reality.
Learn more about how we can work together to improve medication adherence by delivering prescription price transparency.