Pharmacist-led medication non-adherence intervention: reducing the economic burden placed on the Australian health care system
Received 19 October 2018
Accepted for publication 27 March 2019
Published 23 May 2019 Volume 2019:13 Pages 853—862
Checked for plagiarism Yes
Review by Single-blind
Peer reviewers approved by Dr Amy Norman
Peer reviewer comments 4
Editor who approved publication: Dr Johnny Chen
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-Cardenas1
1Graduate 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, Australia
Background: 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
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