Non-adherence to medication has serious consequences for both plan members and sponsors, but for some patients with chronic conditions, using a mail-order pharmacy may improve their health outcomes, according to Joseph Hanna, director of pharmacy at Costco Wholesale.
Chronic disease is prevalent among Canadian adults, with three out of five Canadians over the age of 20 reporting a chronic illness and more than half of adults taking at least one prescription, Hanna told attendees at the 2016 Pharmacy Solutions in Drug Plan Management Conference in Mississauga, Ont.
At the same time, non-adherence to medication — by taking a drug at the wrong time, taking too much or little of their prescription or not starting it at all — is a problem for many of those patients.
For example, half of those with high cholesterol stop their statin medication after only six months of treatment, said Hanna.
Read: A look at the service pharmacists can provide
There are a multitude of reasons for not adhering to a medication, said Hanna, citing affordability, time constraints, accessibility, complexity of treatment and forgetfulness. Poor health outcomes are often the consequence.
Disability carries a high cost for plan sponsors, including an average rate of absenteeism of seven days per employee, a cost per employee of up to three per cent of the payroll and the cost of more prescriptions and hiring a replacement worker, Hanna noted.
“We know that if we have better adherence, we can reduce absenteeism, we can gain some productivity and get folks back to work again,” he said.
In light of those issues, mail-order prescriptions can help improve health outcomes for plan members, according to Hanna. Using that process, patients either mail in the prescription themselves or the doctor faxes or calls it in.
The pharmacy processes the prescription, the patients receive the medication in the mail and 90 days later, they receive their refill.
Read: New research sheds light on plan sponsor thoughts on pharmacy services
At the moment, less than 0.5 per cent of prescriptions in Canada are filled via mail order, compared with 11 per cent in the United States, said Hanna, who expects the Canadian numbers to increase over time.
“One study showed that individuals who received their mail-order refills, as opposed to their local pharmacy, were more likely to have good adherence to their medications for diabetes, high blood pressure and cholesterol. They were also, on average, 15 per cent more adherent to their medications and they had 16 per cent fewer emergency room visits,” Hanna told attendees.
For plan members, there are a number of benefits to filling a prescription via mail order: convenience, easier access to medications, improved adherence and lower costs for a 90-day maintenance supply.
Although the process isn’t ideal for acute situations, Hanna it works very well for chronic conditions.
Read more stories from the Pharmacy Solutions in Drug Plan Management Forum