When plan members don’t take their medications for chronic conditions, it can also have a negative impact on employers’ drug plans.
According to a Sun Life report, Take your pills – Gaining the benefits of improved drug adherence, it may lead to increased benefit costs, lost productivity, temporary disability and increased absenteeism.
Non-adherence also leads to $4 billion in costs to the country’s healthcare system, 5% of Canadian hospital admissions and 5% of physician visits.
The report notes there are several causes of non-adherence, including the characteristics of the patients, the disease and the medication itself.
Characteristics of the patients — Individuals are motivated by different triggers, which can, in turn, change or maintain behaviour. Solving for non-adherence can mean deciphering complex patient motivators and tailoring strategies specifically for that person. And there are some groups that are more at risk than others. For example, clinically depressed patients—or those with another underlying condition that impacts mental health—are more likely to be non-adherent.
Characteristics of the disease — In many cases, conditions with no symptoms, or those that have symptom-free periods, are more likely to lead to non-adherence, as they do not remind patients to take their medication. Also, if a condition requires the patient to take more than one drug, the likelihood of missing or mixing up the dosage, timing or sequencing is far greater. Chronic conditions and lifelong treatment are also risk factors for non-adherence.
Characteristics of medication — Experiencing side effects is perhaps the single largest cause of non-adherence. Medication that is perceived to diminish a patient’s quality of life—or causes
other physical or mental health issues—is less likely to be taken as prescribed. But it’s not just side effects that can lead to non-adherence. The packaging and overall formulation of the medicine can also play a role. Complicated packaging (such as childproof vials) or complex treatments (such as having to take more than one dose a day or using an inhaler or other device) can have a negative impact on adherence.
“Over the long term, increased drug adherence can provide a significant benefit to patients, employers and the Canadian healthcare system,” says Jean-Michel Lavoie, pharmacist and director, pharmaceutical benefits, with Sun Life Financial. “Increasing engagement and education surrounding drug adherence will result in a reduction of many additional costs that your benefits plan and employees may be absorbing, as well as fewer hospital visits and slower disease progression.”