By David Pittman, Contributing WriterHealth Behavior News Service
A new study in the journal Health Services Research shows that diabetes patients who do a better job of taking their medication have slightly lower health care costs.
However, “it’s not a huge effect,” said lead investigator Bruce Stuart, a professor at the University of Maryland School of Pharmacy in Baltimore.
Researchers found that patients who take statin drugs to control cholesterol levels for their diabetes could realize $832 in savings over three years if they increased their medication adherence by 10 percent. The same increase in medication adherence from patients taking ACE-inhibitors, a class of antihypertensive drug, was associated with $285 lower Medicare costs over a three-year period. A 10 percentage-point increase is equal to taking three more pills a month if a patient were prescribed one a day for a 30-day month.
“This is a commonsensical notion that better adherence to drugs that are recommended should have impacts that could plausibly save money,” Stuart said. “Our conclusion is, yeah, it’s there, but it's a pretty modest saving.”
Stuart and colleagues followed about 4,000 Medicare patients who had diabetes diagnoses. Researchers asked the patients to track their pill counts and derived estimated spending costs from Medicare data. Their findings conflict with some published data on the correlation between medication adherence and medical savings.
“There is literature out there that suggests that you could cut the total health spending by a third or more if you just made people more adherent with the drugs that they should be taking,” Stuart said.
Studies have a difficult time linking medication adherence with cost savings. “It may be the people who take their pills regularly also regularly exercise and watch their diet and conform to all the requirements, so it’s hard to separate them,” said Robert Henry, president of medicine and science for the American Diabetes Association.
Because factors other than medication adherence influence a patient’s health, other outcomes such as overall quality of life are also tough to measure. “I think a general statement can be made that the more compliant one is, the better their quality of life, the lower their complication rate and probably a greater longevity,” Henry said.
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Health Services Research is the official journal of the AcademyHealth and is published by John Wiley & Sons, Inc. on behalf of the Health Research and Educational Trust. For information, contact Jennifer Shaw, HSR Business Manager at (312) 422-2646 or [email protected]. HSR is available online at www.blackwell-synergy.com/loi/hesr.
Stuart B, et al. Does medication adherence lower Medicare spending among beneficiaries with diabetes? Health Services Research online 2011.
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