Anyone who has suffered through a chronic illness or cared for a loved one who needs at least a half dozen medications a day knows how complicated the drug regimen can get.
Pills for the morning. More pills at midday, some perhaps some on an empty stomach, others after eating some food, and a few more before bed. Studies show the potential confusion — and the lack of adherence to the regimen — costs the health care industry millions of dollars every year.
But a partnership of MedStar Health and CVS Health may have found a simple solution. The secret to getting it right: Have the pharmacy pre-package and label patients' medications in multi-dose pouches.
Through a pilot program, MedStar officials say a group of 10 primary care offices recently improved medication compliance among patients taking six or more drugs a day from 60 percent to more than 90 percent.
A 10 percent improvement in adherence would have been huge success, said Dr. Steve Evans, executive vice president for Medical Affairs and chief medical officer for MedStar Health. More than 30 percent "is monstrous."
"From our perspective it's a huge impact for the patients, it doesn't cost them anymore, it's easy, it's mailed to them or they can pick it up ... this is just a better way to deliver medicines to people who have to be on a lot of meds," Evans said.
The project was part of a partnership launched between the Columbia, Maryland-based health system and CVS Health in 2014, through which MedStar's electronic patient medical records are linked to CVS locations — an outgrowth of MedStar’s expansion of outpatient care in the region.
MedStar became the 41st health system to partner with CVS, but it was the first health system in the U.S. to deploy CVS Pharmacy multi-dose packs, officials said. The packs are already covered by many insurance plans and available in Maryland, D.C., and Virginia, as well as more than a dozen other states.
MedStar plans to expand the offering to 300 additional primary care physicians, Evans said. The program brings potential cost savings from, for example, reducing the number of emergency department visits and hospitalizations.
Evans declined to specify estimates of how much money the health system could save through improved adherence. As Jane Brody recently wrote in the New York Times, studies show approximately 50 percent of medications for chronic disease are not taken as prescribed. According to a review published in Annals of Internal Medicine, the lack of adherence causes about 125,000 deaths and 10 percent of hospitalizations and costs health systems up to $289 billion a year.
