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Following a daily medication regimen is a fact of life for most adults; nearly seven in ten Americans between the ages of 40–79 used at least one prescription drug in the past 30 days[1] and nearly nine in ten adults over the age of 65 report that they are currently on prescriptions.[2] Taking medications as prescribed by medical professionals for the appropriate amount of time, or medication adherence, is essential for controlling chronic illnesses and overall long-term health and well-being. We also know nonadherence, when patients either don’t take the medication in the correct dose or frequency or abandon treatment completely, is a persistent public health issue which can be mitigated with the proper medical adherence strategy.
The CDC says[3] 20 to 30 percent of new prescriptions are never filled at the pharmacy. Additionally, medication is not taken as prescribed 50 percent of the time. For patients prescribed medications for chronic diseases, after six months, the majority take less medication than prescribed or stop the medication altogether. Medication lapsing can be caused by members forgetting to refill, needing advice on side effects, feeling better and believing they don’t need a refill, and not knowing how to fill their prescription or the medication is discontinued.
Working with one of the largest national healthcare providers, Avantive Solutions developed a proprietary management strategy to target members who needed assistance filling lapsed prescriptions, and increased medication adherence to promote healthier living. This member engagement strategy combined innovative outbound dialing technology, outreach strategies, and data analytics. The use of demographic and geographic data allowed for prioritization of leads and defined the best time to call in order to generate a high patient contact rate.
Avantive Solutions’ consultants reviewed prescription adherence benefits with the healthcare member and discussed various program options to help the member stay updated on their critical medications. When a member was interested in renewing their prescription, the consultant reviewed options such as auto-renewal setup or mail order prescriptions before connecting them directly with their pharmacy.
Despite the value and ease of implementing a robust medication adherence program, the average star ratings have remained at about 3.4 out of 5.0 for the last four years, from 2018-2021 [4]. In addition to contributing to Medicare STARS improvement, a robust medication adherence program could save lives, reduce unneeded hospital readmittance and help members avoid unnecessary expenses and doctor visits. CVS estimates $300 billion in unnecessary medical expenses could be saved each year in addition to saving tens of thousands of lives[5].
To learn more about Avantive Solutions and their innovations in rich call data and advanced machine learning, please visit www.avantivesolutions.com.
[1] https://www.cdc.gov/nchs/products/databriefs/db347.htm
[2] https://www.kff.org/health-reform/issue-brief/data-note-prescription-drugs-and-older-adults/
[3] https://www.fda.gov/drugs/special-features/why-you-need-take-your-medications-prescribed-or-instructed#:~:text=Simply%20put%2C%20not%20taking%20your,worse%2C%20hospitalization%2C%20even%20death
[4] https://www.cms.gov/files/document/2021starratingsfactsheet-10-13-2020.pdf
[5] https://www.cvshealth.com/news-and-insights/articles/improving-medication-adherence
