By using this site, you agree to the Privacy Policy and Terms of Use.
Accept
Health Works CollectiveHealth Works CollectiveHealth Works Collective
  • Health
    • Mental Health
    Health
    Healthcare organizations are operating on slimmer profit margins than ever. One report in August showed that they are even lower than the beginning of the…
    Show More
    Top News
    headphones can create health problems
    The Harmful Health Effects of Using Headphones
    September 24, 2021
    Headache causes
    4 Causes Of Headache You Probably Didn’t Know About
    December 28, 2021
    follow these steps to recover from your injury
    What Steps Should You Take to Recover More Quickly from an Injury?
    April 12, 2022
    Latest News
    Grounded Healing: A Natural Ally for Sustainable Healthcare Systems
    May 16, 2025
    Learn how to Renew your Medical Card in West Virginia
    May 16, 2025
    Choosing the Right Supplement Manufacturer for Your Brand
    May 1, 2025
    Engineering Temporary Hospitals for Extreme Weather
    April 24, 2025
  • Policy and Law
    • Global Healthcare
    • Medical Ethics
    Policy and Law
    Get the latest updates about Insurance policies and Laws in the Healthcare industry for different geographical locations.
    Show More
    Top News
    Do You Know What’s in Your Pain Pill?
    May 11, 2011
    Depression and Diabetes Linked
    June 23, 2011
    Positive Health and the Heart
    July 28, 2011
    Latest News
    Building Smarter Care Teams: Aligning Roles, Structure, and Clinical Expertise
    May 18, 2025
    The Critical Role of Healthcare in Personal Injury Recovery: A Comprehensive Guide for Victims
    May 14, 2025
    The Backbone of Successful Trials: Clinical Data Management
    April 28, 2025
    Advancing Your Healthcare Career through Education and Specialization
    April 16, 2025
  • Medical Innovations
  • News
  • Wellness
  • Tech
Search
© 2023 HealthWorks Collective. All Rights Reserved.
Reading: Medication Non-Adherence: A $290 Billion Unnecessary Expenditure
Share
Notification Show More
Font ResizerAa
Health Works CollectiveHealth Works Collective
Font ResizerAa
Search
Follow US
  • About
  • Contact
  • Privacy
© 2023 HealthWorks Collective. All Rights Reserved.
Health Works Collective > Policy & Law > Health Reform > Medication Non-Adherence: A $290 Billion Unnecessary Expenditure
BusinessHealth Reform

Medication Non-Adherence: A $290 Billion Unnecessary Expenditure

Ashish Varshneya
Last updated: April 13, 2015 8:00 am
Ashish Varshneya
Share
4 Min Read
medical nonadherence
SHARE

medical nonadherence

medical nonadherence

Drug therapy problems present a serious issue in healthcare in the United States.  Industry estimates suggest total costs of unnecessary medical expenditures resulting from medication non-adherence to be approximately $300 billion, which represents more than 30% of the total waste (excluding fraud and abuse) in the healthcare system.  Failure to take prescribed medications costs over $100 billion a year in excess hospitalizations.  It is estimated that nearly one-third of patients never fill their prescriptions, and three out of four Americans do not take their medications as directed.

Medication Therapy Management (MTM) includes a broad range of activities, including but not limited to enhancing adherence through patient education, performing a comprehensive review of the patient’s drug regimen, and monitoring efficacy and safety of medication therapy, with the overall objective to enhance care outcomes and lower healthcare costs.

More Read

frequent ER users
Myth: Frequent ER Users Don’t Use Primary Care
Medicaid Should Not Impoverish Doctors and Hospitals
Radiofrequency Ablation Market Continued Growth Strong Globally
Challenges of Stage 2 Meaningful Use Require More Allies
Your Employees Are Your Best Brand Ambassadors

Market Drivers: While the Medicare Modernization Act of 2003 required Medicare Part D prescription drug plans to include medication therapy management services to be delivered by a qualified healthcare professional, lack of financial incentives and a quantifiable ROI were key challenges in implementing an effective medication therapy management.

The introduction of the 5-Star rating system by the Affordable Care Act provides the financial incentives and puts MTM in the spotlight.  Of the 53 key quality measures in the Medicare Star rating system, 17 are prescription drug specific and have a weighting of 1.5 to 3x making it a highly important component for the overall plan rating.  With Star Ratings bonus payments expected to exceed $2 billion for the large, public MCOs in 2015 alone, MTM has come into high focus.

Two Compelling MTM Case Studies: 

  • The 37-year-old female who is taking 18 medications. The patient suffered from uncontrolled asthma, plus depression, pain, and nausea.  A 30-minute MTM visit found five problems, including a duplicate therapy and overuse of a short-acting inhaler.  Three medications were added, one subtracted. The annual medication costs: $3,092. Cost reductions from avoiding an asthma-related hospital stays: $24,511 (average costs of a hospital visit by a patient suffering from asthma).  Net savings: $21,419.
  • The 54-year-old man who is taking 12 medications. The patient was a smoker who has diabetes and other problems.  The MTM check-up identified four problems, including adherence issues and a missing ACE-I therapy.  Three medications were changed; adherence was improved.  Net savings: $9,567.

Market Activity Provides Further Validation:  Market activity, as demonstrated by selected events below, further validates the MTM’s renewed focus in the minds of several market constituents.

  • CMS awarded $8.7 million to VillageCare, a community-based, not-for-profit organization, to help HIV/AIDS patients by providing a multi-layered and tailored intervention aimed at improving their medication adherence via a mobile medication planner, text reminders, social networking, peer mentoring, virtual support groups, and virtual access to health coaches.
  • First Databank (part of Hearst Health) has partnered with Polygot, a developer of cloud-based adherence platform for hospitals, ambulatory care centers, and pharmacies across the U.S. and Canada to enhance adherence through patient education and awareness tools. Providers will benefit from improved quality scores.

An ongoing and irreversible shift to ‘value-based’ care models that align reimbursement with the delivery of higher quality and more cost-effective care will have a profound impact on MTM.  In addition, an effective MTM program can dramatically improve adherence and patient health through regimented chronic condition management, eliminate fear of medication related side-effects through patient education, proactively identify medication adherence gaps, and drive appropriate interventions.

Let us know what you think.

Medical non-adherence / shutterstock

Share This Article
Facebook Copy Link Print
Share

Stay Connected

1.5kFollowersLike
4.5kFollowersFollow
2.8kFollowersPin
136kSubscribersSubscribe

Latest News

Clinical Expertise
Building Smarter Care Teams: Aligning Roles, Structure, and Clinical Expertise
Health care
May 18, 2025
Grounded Healing: A Natural Ally for Sustainable Healthcare Systems
Grounded Healing: A Natural Ally for Sustainable Healthcare Systems
Health
May 15, 2025
Learn how to Renew your Medical Card in West Virginia
Learn how to Renew your Medical Card in West Virginia
Health
May 15, 2025
Dr. Klaus Rentrop Shares Acute Myocardial Infarction heart treatment
Dr. Klaus Rentrop Shares Acute Myocardial Infarction
Cardiology
May 13, 2025

You Might also Like

Business

HealthCare Marketing: Choosing the Right Healthcare Advertising Channel

February 18, 2013

How will Preventative Care Initiatives Impact Hospital Staff?

October 26, 2015

Medicaid: Not Just for the Poor Anymore

March 7, 2011
Worst Mistakes Healthcare Org. Make When Trying to Attract Patients from the Internet
BusinesseHealthFinance

Benign Neglect: Classic Internet Mistake

January 25, 2014
Subscribe
Subscribe to our newsletter to get our newest articles instantly!
Follow US
© 2008-2025 HealthWorks Collective. All Rights Reserved.
  • About
  • Contact
  • Privacy
Welcome Back!

Sign in to your account

Username or Email Address
Password

Lost your password?