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
    learn to recognize and treat yeast infections
    Most Commonly Asked Questions About Yeast Infections
    November 17, 2021
    Advanced lung cancer diagnosis systems used by doctors
    Advanced Lung Cancer Diagnosis Systems Used by Doctors
    March 6, 2022
    The Top Benefits of a Wearable Blood Pressure Monitor Watch
    The Top Benefits of a Wearable Blood Pressure Monitor Watch
    June 13, 2022
    Latest News
    7 Most Common Healthcare Accreditation Programs: Which Should You Use?
    August 20, 2025
    Hospital Pest Control and the Fight Against Superbugs
    August 20, 2025
    Hygiene Beyond The Clinic: Attention To Overlooked Non-Clinical Spaces
    August 13, 2025
    5 Steps to a Promising Career as a Healthcare Administrator
    August 3, 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
    Life Expectancies and Lethal Injections
    May 6, 2015
    The Future of Healthcare and Big Pharma is in Big Data Analytics
    February 5, 2021
    Financial Assistance for Clinical Trials
    September 16, 2015
    Latest News
    How Social Security Disability Shapes Access to Care and Everyday Health
    August 22, 2025
    How a DUI Lawyer Can Help When Your Future Health Feels Uncertain
    August 22, 2025
    How One Fall Can Lead to a Long Road of Medical Complications
    August 22, 2025
    How IT and Marketing Teams Can Collaborate to Protect Patient Trust
    July 17, 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
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

patient data security
7 Great Tips for Securing Personal Health Information
Surgical Sealants and Glues in the Balance of Wound Closure
Is a Government Takeover of Health Care Underway?
Hashtags for Healthcare
The One Medicare Program that Actually Works

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

engineer fitting prosthetic arm
How Social Security Disability Shapes Access to Care and Everyday Health
Health care
August 20, 2025
a woman explaining the document
How a DUI Lawyer Can Help When Your Future Health Feels Uncertain
Public Health
August 20, 2025
physiotherapist at work
How One Fall Can Lead to a Long Road of Medical Complications
Health care
August 20, 2025
Common Healthcare Accreditation Programs
7 Most Common Healthcare Accreditation Programs: Which Should You Use?
Health News
August 20, 2025

You Might also Like

Lean_Processes
Business

The Benefits of Lean Processes in Radiology Practice Management

November 30, 2014
online appointments could be either permanent or a temporary trend
BusinessHospital AdministrationNews

Are Online Doctor’s Appointments a Trend or New Reality?

December 23, 2021

e-Patients, Quantified Self and Self-Efficacy; Self-Monitoring Through Technology

November 7, 2011
Health ReformPolicy & Law

Medical Overdiagnosis and Overtreatment – Do Physicians Want Cost Control?

March 31, 2013
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?