Improve Patient Adherence and Persistence to Medications

The Problem

Close to 30 percent of all prescriptions written are never filled. Over half of filled prescriptions are taken in a manner that deviates from the prescriber's intent or are discontinued without the prescriber's approval.

The Impact

Medication non-adherence contributes to 125,000 deaths each year and is linked to 10 percent of hospital admissions and 23 percent of admissions to long-term care facilities. It is estimated that over $300 billion are spent in healthcare yearly due to inadequate control of disease and treatment of adverse drug reactions. In addition to the public health impact, this is a huge financial loss to pharmacies and the pharmaceutical industry.

The Solution

Pharmacists need assistance to detect patients' non-adherence and to guide them in responding effectively. The solution must provide a viable business model for pharmacies that specialize in compliance care. Freedom Data Services developed ComplyChek^®, reporting protocols to provide an integrated practice solution for the serious and expensive problem of medication non-adherence.

A New Paradigm

With ComplyChek, pharmacists are paid for managing medications while patients and payors realize improved effectiveness, safety and value from prescribed medication therapy.

Keys To Success

• Real-time alerts to pharmacies
• Target Intervention Strategies
• Performance Benchmarks and Goals
• Financial Incentives to Pharmacies

Practice Model

Enrollment

• The patient enrolls in the service via an opt-in or opt-out self-selection process.
• The drug product is enrolled by a sponsor (e.g., drug manufacturer, insurer, PBM) who wants to optimize adherence to prescribed therapy for a selected drug product.
• An adherence target is set for each enrolled drug product.
• At refill, the prescription claim is transmitted to FDS, the program administrator.
• FDS calculates an Adherence Index (AI), a summary index measure of medication adherence, and compares it with the target value for the drug.

Electronic Alerts

• If the patient is determined to be outside of the target adherence range, FDS sends an electronic alert instructing the pharmacist to confirm or disconfirm the possible adherence problem.
• Each patient's AI value is recalculated and recompiled daily following the initial prescription fill. The pharmacy is alerted if the patient is out of target range, even if the patient does not return for a refill.

Pharmacy Response

• If the electronic alert is confirmed, the pharmacist selects, implements and documents a corrective intervention strategy matched to the reason(s) or cause(s) for the non-adherence.

Fee for Service

• Pharmacies are paid standard fees based on fair market value of the intervention services performed.

Reports

• Performance benchmarks are calculated within and across participating pharmacies to measure improvement in medication adherence.
• A secure FDS web page allows each participating pharmacy to view updated adherence reports for every enrolled patient and prescription.