CVS Insights

A direct link between medication adherence and lower health care cost

CVS Caremark is very focused on medication adherence and on ways we can make health care more affordable and more effective by helping our CVS/pharmacy patients and our pharmacy benefit plan members better understand the benefits of staying on their medications. And whether you’ve heard it from us or from others, you’re also probably aware of the overall impact that medication adherence has on the cost of health care – an impact of nearly $300 billion, according to the New England Healthcare Institute.

But what you probably do not yet know is the direct link between the per-patient savings that are created when patients take their medications and stay on them for the full course of their prescriptions. Researchers have shown that patients who are adherent spend less on health care, but their research has never been able to separate the value of medication adherence from other factors like diet and exercise to get at the true cost of non-adherence.

But CVS Caremark researchers published a paper in the journal Health Affairs that documents the true value of medication adherence. The research clearly shows that while chronically ill patients who remain adherent may spend more on medications – as much as $1,000 more annually – their overall health care costs are significantly lower than those paid by non-adherent patients.

For example, patients with congestive heart failure spend $7,823 less on health care annually if they stay on their prescribed medications, the research shows. Adherence lowers the medical bills for patients with diabetes by $3,756 every year. Treatment for hypertension costs $3,908  less per patient per year if they are adherent, and patients with dyslipidemia or high cholesterol on average spend $1,258 less every year if they stay on their medications. The study population included patients in the CVS Caremark book of business with these conditions.

The financial upside of adherence is especially pronounced in patients aged 65 and older, according to the paper, which urges health care policy analysts to focus on the potential for medication adherence to drive significant long-term savings across the entire U.S. health care system.

This work complements an ongoing research partnership with Harvard and Brigham and Women’s Hospital to use the resulting knowledge not only to sharpen our own approach to important health care challenges like medication adherence, but also to advance the broader health care community’s understanding of these issues. With interested observers exploring the ramifications of our findings, we are excited to see the community taking note of this new evidence of the economic importance of adherence.