Patient Preference and Adherence (May 2019)
Pharmacist-led medication non-adherence intervention: reducing the economic burden placed on the Australian health care system
Abstract
Rachelle Louise Cutler,1 Andrea Torres-Robles,1 Elyssa Wiecek,1 Barry Drake,2 Naomi Van der Linden,3 Shalom I (Charlie) Benrimoj,4 Victoria Garcia-Cardenas11Graduate School of Health, University of Technology Sydney, Sydney, NSW, Australia; 2Faculty of Engineering and Information Technology, University of Technology Sydney, Sydney, NSW, Australia; 3AstraZeneca Netherlands, The Hauge, Netherlands; 4Sydney University, Sydney, NSW, AustraliaBackground: Scarcity of prospective medication non-adherence cost measurements for the Australian population with no directly measured estimates makes determining the burden medication non-adherence places on the Australian health care system difficult. This study aims to indirectly estimate the national cost of medication non-adherence in Australia comparing the cost prior to and following a community pharmacy-led intervention.Methods: Retrospective observational study. A de-identified database of dispensing data from 20,335 patients (n=11,257 on rosuvastatin, n=6,797 on irbesartan and n=2,281 on desvenlafaxine) was analyzed and average adherence rate determined through calculation of PDC. Included patients received a pharmacist-led medication adherence intervention and had twelve months dispensing records; six months before and six months after the intervention. The national cost estimate of medication non-adherence in hypertension, dyslipidemia and depression pre- and post-intervention was determined through utilization of disease prevalence and comorbidity, non-adherence rates and per patient disease-specific adherence-related costs.Results: The total national cost of medication non-adherence across three prevalent conditions, hypertension, dyslipidemia and depression was $10.4 billion equating to $517 per adult. Following enrollment in the pharmacist-led intervention medication non-adherence costs per adult decreased $95 saving the Australian health care system and patients $1.9 billion annually.Conclusion: In the absence of a directly measured national cost of medication non-adherence, this estimate demonstrates that pharmacists are ideally placed to improve patient adherence and reduce financial burden placed on the health care system due to non-adherence. Funding of medication adherence programs should be considered by policy and decision makers to ease the current burden and improve patient health outcomes moving forward.Keywords: medication adherence, community pharmacy, big data, dispensing records, health economics
