Pharmacist-led medication non-adherence intervention: reducing the economic burden placed on the Australian health care system

Rachelle Louise Cutler; Andrea Torres-Robles; Elyssa Wiecek; Barry Drake; Naomi Van der Linden; Shalom I Charlie Benrimoj; Victoria Garcia-Cardenas

doi:10.2147/PPA.S191482

Pharmacist-led medication non-adherence intervention: reducing the economic burden placed on the Australian health care system

Patient Prefer Adherence. 2019 May 23:13:853-862. doi: 10.2147/PPA.S191482. eCollection 2019.

Authors

Rachelle Louise Cutler¹, Andrea Torres-Robles¹, Elyssa Wiecek¹, Barry Drake², Naomi Van der Linden³, Shalom I Charlie Benrimoj⁴, Victoria Garcia-Cardenas¹

Affiliations

¹ Graduate School of Health, University of Technology Sydney, Sydney, NSW, Australia.
² Faculty of Engineering and Information Technology, University of Technology Sydney, Sydney, NSW, Australia.
³ AstraZeneca Netherlands, The Hauge, Netherlands.
⁴ Sydney University, Sydney, NSW, Australia.

Abstract

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: big data; community pharmacy; dispensing records; health economics; medication adherence.