Buried within a New York Times article about the costs of nonadherence to prescribed medication—in both financial and human terms—resides yet another argument for value-based health care. Nonadherence “partly explains why new drugs that perform spectacularly well in studies, when patients are monitored to be sure they follow doctors’ orders, fail to measure up once the drug hits the commercial market.”

The Times was reporting on a megastudy in the Annals of Internal Medicine. Researchers assert that lack of adherence costs the health care system anywhere from $100 billion to nearly $300 billion a year and those numbers include about 10% of hospitalizations. The human toll? They estimate that it causes about 125,000 deaths a year.

The study states that, “Studies have consistently shown that 20% to 30% of medication prescriptions are never filled, and that approximately 50% of medications for chronic disease are not taken as prescribed.”

Of course, cost is a factor. Researchers “found robust evidence that reduced out-of-pocket expenses improved medication adherence across clinical conditions. With regard to clinical outcomes, we found the strongest evidence that improved medication adherence was accompanied by improved clinical outcomes with pharmacist-led hypertension management interventions for systolic blood pressure improvement and case management interventions for depression symptoms. We also found evidence that education with behavioral support; reminders; and pharmacist-led, multicomponent interventions enhanced adherence across more than 1 clinical area.”

Yet, it’s not just cost. There’s a huge societal push for the natural cure. Lisa Rosenbaum, a cardiologist at Brigham and Women’s Hospital in Boston, tells the Times: “The emphasis on diet and exercise convinces some people that they don’t have to take medications.”

Source: Annals of Internal Medicine