Medication Adherence Reviews

The medication adherence review is a systematic process of collecting patient-specific information, assessing medication therapies to identify critical medications which are absent or seemingly absent from therapy. The reviews can be comprehensive or targeted to an actual or potential medication problem. Whether comprehensive or targeted, the individual patient’s medications are evaluated in the context of the patient as a whole, taking into consideration all of the patient’s conditions and medication therapies.

Why is Medication Adherence needed?

Medications are important to the management of chronic diseases that require long-term or lifelong therapy. Pharmacists are uniquely qualified as medication experts to work with patients to manage their medications and chronic conditions and play a key role in helping patients take their medications as prescribed.

Non-adherence with medications is a significant problem. According to a report by the World Health Organization, in developed countries, only 50 percent of patients with chronic diseases adhere to medication therapies. For example, in the United States, only 51 percent of patients taking blood pressure medications and only 40 to 70 percent of patients taking antidepressant medications take their medications as prescribed.

Failure to follow medication therapy regimens costs over $290,000,000,000 annually. The problem of non-adherence is particularly important for patients with chronic diseases that require use of medications. Poor adherence leads to unnecessary disease progression, reduced functional status, lower quality of life, and premature death.

When patients adhere to or comply with prescribed medication therapy it is possible to reduce higher-cost medical attention, such as emergency department visits and catastrophic care, and avoid the preventable human costs that impact patients and the individuals who care for them.

Studies have clearly demonstrated that community-based medication therapy management services provided by pharmacists improve health care outcomes and reduce spending.

Physician-prescribers and members are much more likely to accept and implement recommendations from independent clinical pharmacists who are not associated with the PBM. Consequently, PPCN’s Medication Adherence activities yield superior results to traditional programs.

PPCN is 100% independent and fully committed to improving patient outcomes, which generates savings for the plan sponsor and its members. It has no ties to pharmaceutical firms or other major health care vendors. And, there are no rebate arrangements or soft-dollar reimbursements that can influence PPCN’s work.

Everything that PPCN does for its clients is 100% transparent. The analyses performed and the cost savings recommendations will be fully explained in laymen’s terminology.

This program uses a targeted approach with a focus on effectiveness and cost

o There is a high level of communication between pharmacist, patient and physician in this program.

o Using claims analysis, high risk patients will be identified based upon targeted disease states and targeted therapeutic drug classes.

o A Clinical Pharmacist will review each patient’s medication profile to identify missing therapy or poor adherence to therapy.

o The Clinical Pharmacist will create an action plan consisting of recommendations to address therapeutic issues.

o The Clinical Pharmacist will communicate with the physician and the patient to act upon recommendations.

o Using claims analysis, the actions taken based upon the Clinical Pharmacist’s recommendations will be reconciled.

o Using the original action plan and the claims analysis, a report quantifying the initial adherence recommendations and the actual adherence recommendations followed will be provided for the client.

o The Clinical Pharmacist will conduct a patient compliance consultation to review the changes in drug therapy.

Benefits

o Rapid results are seen by patient and the employer, as the patient’s drug regimen can be changed quickly and the employer can begin cost avoidance measures.

o Reduction of physician visits, emergency room visits, hospitalizations, tests and procedures due to less than effective or inappropriate therapy.

o The new drug regimen should yield improved clinical results when compared to the previous therapy.

o The program can generate a 2:1 Return on Investment.

Pricing

Fee: $200.00 per patient per adherence review.

For more information contact;

Scott Moss
Vice President Sales & Marketing
336-542-7844
Scott.Moss@EmailMM.com