ClinicoEconomics and Outcomes Research (Oct 2024)
Improving Adherence and Reducing Health Care Costs Through Blister-Packaging: An Economic Model for a Commercially Insured Health Plan
Abstract
Eric P Borrelli,1 Peter Saad,2 Nathan E Barnes,2 Doina Dumitru,3 Julia D Lucaci4 1Health Economics & Outcomes Research (HEOR), Becton, Dickinson and Company, San Diego, CA, USA; 2Medical Affairs, Becton, Dickinson and Company, Durham, NC, USA; 3Medical Affairs, Becton, Dickinson and Company, San Diego, CA, USA; 4Health Economics & Outcomes Research (HEOR), Becton, Dickinson and Company, Franklin Lakes, NJ, USACorrespondence: Eric P Borrelli, Health Economics & Outcomes Research (HEOR), Becton, Dickinson and Company, 3750 Torrey View Ct, San Diego, CA, 92130, USA, Email [email protected]: To model the potential clinical and economic impact of blister-packaging medications for chronic conditions on medication adherence and healthcare costs in a commercially insured population.Methods: A health economic model was developed to evaluate the potential impact of blister-packaging chronic medications for a commercially insured population. The chronic medication classes assessed were renin-angiotensin-system (RAS) antagonists, statins, non-insulin oral antidiabetics, and direct oral anticoagulants (DOACs). The model was designed to reflect the perspective of a hypothetical commercially insured health plan with 100,000 members, over a one-year time horizon. Literature-based or best available epidemiologic references were used to inform the number of patients utilizing each medication class, the impact of blister-packaging on the number of patients who become adherent, as well as the impact of medication adherence in a commercially insured population on healthcare costs for each medication class assessed. Impact on costs was measured in total net healthcare costs, as well as being stratified by medical costs and medication costs.Results: Following the blister-packaging intervention, there were an additional 591 patients adherent to RAS antagonists, 1196 patients adherent to statins, 169 patients adherent to oral antidiabetics, and 25 patients adherent to DOACs. While pharmacy costs increased, these costs were more than offset by the reduction in medical costs. Overall, the increase in patients adherent to therapy due to blister-packaging led to a reduction in total healthcare costs of $879,312 for RAS antagonists (-$0.73 per-member per-month (PMPM)), $343,322 for statins (-$0.29 PMPM), $78,917 for oral antidiabetics (-$0.07 PMPM), and $120,793 for DOACs (-$0.10 PMPM).Conclusion: Blister-packaging chronic medications in a commercially insured population has the potential to reduce healthcare costs. Future research is needed to confirm these findings in real-world settings and to fully understand the clinical and economic implications of blister-packaging chronic medications.Plain Language Summary: Patients not taking their medications as prescribed is common in the United States, leading to disease progression, increased healthcare visits, and increased healthcare costs. Blister-packaging medications is an intervention shown to increase medication adherence, or patients taking their medication as prescribed, and has been around for several decades. While there is research and literature available that shows the impact that blister-packaging medications has on improving adherence, and there is literature available that shows patients taking their medications as prescribed reduces healthcare costs, there is minimal literature available that directly ties these two concepts together. As a result, we modeled from a hypothetical commercial insurance health plan perspective what the impact would be of blister-packaging chronic medications on healthcare costs using the best available peer-reviewed literature and epidemiologic data. This analysis found that for a commercially insured health plan with 100,000 members, 591 additional patients would become adherent to their renin-angiotensin-system (RAS) antagonists blood pressure medications, 1196 additional patients would become adherent to their statins, 169 additional patients would become adherent to their oral antidiabetics, and 25 additional patients would become adherent to their direct oral anticoagulants (DOACs). Additionally, this would lead to a reduction in healthcare costs for the health plan of $879,312 for RAS antagonists (-$0.73 per-member per-month (PMPM)), $343,322 for statins (-$0.29 PMPM), $78,917 for oral antidiabetics (-$0.07 PMPM), and $120,793 for DOACs (-$0.10 PMPM).Keywords: medication adherence, medical cost offsets, healthcare costs, total cost of care, medication adherence packaging, blister-packaging, blister-packing, self-insured
