Iscribe medication4/6/2023 A previously announced three-year collaboration with Harvard and Brigham and Women’s Hospital to study claims data “to better understand patient behavior around medication adherence.” The researchers will use “behavioral economics and social marketing” to understand better why patients remain noncompliant to their treatment regimens. This month, CVS Caremark said it is funding the creation of a Behavior Change Research Partnership with three schools, Carnegie Mellon, Dartmouth’s Tuck School of Business, and the University of Pennsylvania’s Wharton School of Business as well as its Medical School. In a statement, CVS Caremark says that its goals “are to promote savings for the patient, payers and employers enhance the customer experience at the pharmacy and improve patient medication compliance which can help improve health outcomes.” InĪt the beginning of the year, CVS Caremark announced that it was switching physicians using its iScribe e-prescribing system over to the EHR system of Allscripts (Chicago see also p. PBMs, which have the combined responsibility of lowering medication costs through bulk purchasing, while at the same time improving health and thus lowering overall costs for their clients (usually, employer-based health plans), have jumped onto adherence as a demonstrable financial benefit. But the theory is that by putting patients in the driver’s seat to manage their healthcare, better adherence should be one of the expected results. It is not clear, however, that the availability of these record-storage and -access functions actually translate into better adherence, or even better overall outcomes. , founded by Google alum Adam Bosworth, will combine the capability of posting one’s own medical records with access to “care plans” created by healthcare professionals for disease conditions or wellness the company received funding from Pfizer last month. Google Health, Microsoft HealthVault, WebMD and others allow consumers to store EHRs. In the past several months, several new online services have been launched to catch the wave of interest in consumer-driven health. The latest trend is to jump on the consumer health bandwagon via the growing number of websites that allow individuals to store their medical records online, as well as to create their own reminders and wellness programs. All of these players are benefiting from the growing digitization of health records, from e-prescribing to full-blown electronic health records (EHRs). Pharmacies and PBMs are stepping up their efforts, partly for competitive reasons. Managed care organizations recognize that better adherence translates into healthier patients and potentially lower costs to client insurers or employer plans. Now there seems to be a trend to make adherence and medication therapy management almost an automatic feature of drug dispensing. Pharma companies have routinely employed service agencies to run adherence programs, and occasionally make use of compliance packaging-blister cards and “calendarized” packages, best exemplified by the well-known containers for birth-control pills. Pharma companies have long tried to address adherence issues, but the primacy of the patient-physician relationship, and patient-privacy rules have limited industry impact. NCPIE, having studied adherence for over 20 years, has called it “the other drug problem,” and issued a major report in 2007 calling for a renewed effort to address it (Pharmaceutical Commerce, Nov/Dec, 2007, p. But the consequences are substantial: An earlier estimate from the New England Healthcare Institute pegged the cost to the US healthcare system of non-adherence, in terms of increased hospital visits, more medical interventions and the like at $290 billion/yr. This statistic pairs up well with the generally believed figure that 50% of patients go off therapy by six months after the initial prescription The reasons are not always adherence-related: cost of medicine, changed prescriptions or other factors also play into the process. Yet 87% believe that prescribed meds will make a difference in their health. Most recently, the National Center for Patient Information and Education (NCPIE Rockville, MD) paired up with Prescription Solutions, a Cypress, CA pharmacy-benefit management company (and unit of insurer UnitedHealth) to find that 54% of US adults do not take meds as instructed, either ceasing consumption early, skipping doses, neglecting to get refills, among other actions. Another year, another batch of studies lamenting the dismal performance of patients on extended medication therapy, such as chronic or longterm conditions.
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