The Impact of Medication Nonadherence on Healthcare Costs

medication nonadherence effects

Our nation is facing a healthcare affordability crisis spurred by the increasing healthcare costs burdening both our national healthcare infrastructure and patients who struggle to afford their medical bills. While these increasing costs don’t originate from a single source, a notable contributing factor is medication nonadherence. This occurs when individuals fail to take their medications as directed for the maximum benefit. Non-adherence stems from cost, complexity, and accessibility, to name a few and the mortality associated with medication nonadherence comes with an estimated annual price tag of over $500 billion. It’s time to get our nation’s medication use under control. 

The trouble with rising healthcare costs

Concerns for patients

Now more than ever, individuals in the US are struggling to afford their healthcare costs. Nearly half of US adults say that they have difficulty in affording their healthcare costs, and as a result, often delay or forgo important healthcare services and medications. 

While the immediate effects of delayed care are obvious, the long-term effects pose a greater threat to patient health. The most delayed types of healthcare include dental work, vision care, visits to the doctor, and mental healthcare. Conditions in each of these areas, if allowed to progress untreated, can create dire consequences later in a patient’s life. In the same vein as delayed care, some patients have resorted to delaying or rationing needed medications to reduce costs. While delaying medical care of any kind is harmful, rationing or forgoing medications to manage chronic conditions is especially dangerous. If allowed to progress, chronic conditions worsen quality of life and ultimately lead to further morbidity and/or mortality. According to a poll conducted in 2020, 44% of respondents stated that they did not purchase at least one medically necessary medication within the last year, due to cost. This alarming trend is a large contributing factor to the tragic 125,000 deaths caused each year by medication nonadherence. 

Concerns for healthcare organizations

It’s not just patients feeling the heat of rising healthcare costs, healthcare organizations and employers are starting to sweat, too. After a 5% increase in healthcare costs in 2022, US employers expect to see a further 6% increase in 2023, resulting in budget overruns for employee healthcare expenditures.  

Hospitals and healthcare organizations are also strained by rising healthcare costs. Throughout the COVID-19 pandemic, rising costs led over 33% of hospitals to operate with negative margins. The high-cost impacts of medication nonadherence make it a critical part of cost control in the US healthcare system, far too important to be ignored.

impact of medication nonadherence

How medication nonadherence contributes to healthcare costs

To begin to understand medication nonadherence’s impact on healthcare costs, we must first understand the extent of nonadherence in the US. It’s estimated that about a third of prescriptions are never filled, with as many as 50% of chronic conditions prescriptions not being taken as directed. Medication nonadherence is unfortunately an epidemic we won’t fix overnight

Worsening health outcomes and increased costs

Disease state progression is the most direct way that medication nonadherence contributes to increased healthcare costs. When patients are unwilling or unable to properly manage their conditions through medication use, those conditions worsen, leading to increased downstream healthcare costs. To be proactive, if we can keep conditions at bay through proper medication adherence and healthy behaviors, not only could we save patientsout-of-pocket costs, but costs for our healthcare system at large. 

Strategies to solve medication nonadherence and reduce healthcare costs

With medication nonadherence being one of the largest problems plaguing our healthcare system, is there a solution? Yes. And it may be simpler than you think.  

Clinical pharmacists. Long gone are the days in which pharmacists must work within the confines of a pharmacy or hospital setting. Now, pharmacists can work independently of traditional environments to focus on one thing and one thing only – their patient. These qualified clinicians possess an untapped potential that may have the power to cure the nonadherence epidemic. Programs led by clinical pharmacists have been shown to improve medication adherence, especially in patients with chronic conditions. Clinical pharmacists’ years of education, training, and residency make them uniquely qualified to lead adherence programs, as top medication experts. Pharmacists’ focus on medications and optimizing their usage means they often have deeper medication knowledge in totality than prescribing physicians.  

What is the best way to deliver clinical pharmacist-led adherence programs at scale? Telephonic outreach. The COVID-19 pandemic and resulting telehealth boom proved that patients can communicate virtually with healthcare providers to address health concerns. And medication use is no exception. Aspen RxHealth’s digital platform revolutionizes pharmacy by allowing clinical pharmacists to work from home, providing medication consultations to patients nationwide. These pharmacist-led outreach programs are increasing patients’ medication adherence levels, lowering health plans’ cost for treatment, and improving patient experience by cutting down on visits to the doctor’s office or numerous phone calls from care managers. Aspen RxHealth pharmacists educate members on the benefits of their medications and addressing questions or concerns presenting adherence barriers. If a health plan member is struggling to afford their medications, Aspen RxHealth pharmacists can assist by directing the member to programs offered by their health plan or state to improve medication affordability. 

Find the right partner to solve medication nonadherence

Health plans across the country are already seeing decreased costs and improved member outcomes through their partnerships with Aspen RxHealth. If you are a pharmacy professional at a health plan looking to reduce costs and get your members to live healthier lives, let’s talk