Study: Proactive Efforts Improve Adherence
Medication adherence is key to managing or limiting the progression of chronic diseases. Simply by taking their medicines as directed, patients may require fewer emergency room visits, hospitalizations, and extra medical tests. Most importantly, they will enjoy better health.
Yet we know that plan sponsors lose billions of dollars annually in medical costs, lost earnings, and lost productivity due to patients not taking their prescriptions as prescribed. But do we know why?
We do and we’re making progress, proven by a recent study, measuring the impact of ScreenRX, which leverages machine learning algorithms to identify at-risk patients combined with tailored clinical care support.
To measure the impact of ScreenRx, we looked at the medication possession ratio (MPR) among members before and after implementation of the program for high cholesterol, high blood pressure, and diabetes.
Our retrospective analysis compared matched patients from clients who implemented the targeted ScreenRx solution in January 2017 (intervention sample) to patients from clients who did not choose to implement the solution (control sample.)
Patients from both groups were selected based on an adherence predictive score identifying them for possible intervention. Based on their predictive scores, those deemed most likely to become non-adherent in the subsequent 6 to 12 months were selected for the analysis. The control and intervention populations were matched by age, gender, and MPR in the pre-period. Therapy adherence was based on MPR at the therapy class level, assessed 365 days before (pre-period) and after (post-period) the program implementation date. Members were determined to be adherent with their medications if their corresponding MPRs were at least 80%.
Express Scripts found that the ScreenRx program drove a sustained and notable positive impact on medication adherence rates supporting positive health outcomes for all 3 medication classes.
- High blood pressure: The group enrolled in the program saw an increase of 15%, compared to 10.6% for those not in the program
- High cholesterol: The group enrolled in the program saw an increase of 20.0%, compared to 11.1% for those not in the program
- Diabetes: While adherence declined in both groups, the decline was less, 20.9%, for those in the program, compared to 26.8% for those not in the program
How ScreenRx Works
ScreenRx applies actionable data, behavioral science, and clinical specialization to improve health for members and financial outcomes for clients.
- Actionable data – Our predictive models allow us to screen early for nonadherence and reach out to patients who are at an elevated risk before adherence becomes a problem.
- Behavioral science – We have learned that 69% of nonadherence is due to behavioral issues such as forgetting or procrastinating, which calls for behavior-based interventions, including renewal assistance and reminder devices.
- Clinical specialization - For those patients with clinical concerns such as side effects, we have specialist pharmacists at our Therapeutic Resource Centers® who are experts at effectively counseling at-risk patients.
Pharmacists: Making the Patient Connection
This is just one example of how ScreenRx works: ScreenRx flagged a patient who was late to refill on five cardiovascular medications, noting that the barrier was potentially cost. A specialist pharmacist reached out to the patient and spoke with the patient’s spouse who confirmed cost was a barrier, but not the only one.
The specialist pharmacist reviewed the patient’s 90-day supply options and their local pharmacy as a cost saving solution. When it was determined that they were in a rural area and interested in home delivery, the pharmacist reviewed with the caregiver the cost savings, retail to mail conversion process, automatic refills & extended payment plan. Retail to mail requests were processed for all the patient’s medications with a potential cost savings of more than $14,000. In addition, the convenience of using automatic fills helped relieve some of the spouse’s burden.
ScreenRx has proven to improve adherence, reduces avoidable medical costs, and closes gaps in care with early detection to identify at-risk patients, patent engagement strategies, and tailored solutions that address patient-specific behavioral, clinical, and cost barriers.