Project lowers costs while improving statin, beta-blocker adherence

A Pennsylvania pharmacy-based intervention program could help patients and insurers alike save money and live healthier lives, according to a study published in the August issue of Health Affairs.

Called the Pennsylvania Project, the initiative utilized local chain and independent pharmacies in an effort to increase adherence to medication and reduce annual healthcare costs. Lead author Janice L. Pringle, PhD, of the University of Pittsburgh School of Pharmacy, and colleagues used a screening and brief model to target five common chronic disease medication classes, including beta-blockers and statins.

Over the course of 12 months in 2011, participating pharmacies were divided between those providing the intervention for patients (29,042 patients, 107 pharmacies) and usual care (30,484 patients, 111 pharmacies). The screen and brief intervention involved providing patients with a series of questions to determine their risk for nonadherence and addressing those at risk with further education on the medication and the importance of taking it.

Pringle et al reviewed insurance claims data, utilizing a measure that monitored the proportion of days to receive the minimum medication dose to achieve clinical outcomes, which they considered to be 80 percent of the expected period.

The research team found that for beta-blockers, the intervention group had a 5 percent increase over pre-intervention adherence. Patients taking statins had a 7 percent increase in adherence. Both groups saw an increase over the control adherence by 3.1 percent and 4 percent, respectively.

Even with healthcare costs increasing between 2010 and 2011, adherence translated into annual savings in inpatient and emergency department costs per patient. Patients on beta-blocker prescriptions had the lower end of the savings, reflecting about $19 per year; however, patients on statins had one of the higher annual savings: $241 per year.

While this seems small, the effect could be huge when considering the insurer perspective. Adherence to the two medications that had the most cost savings, statins and antidiabetics (approximately $341 reduction), could save even smaller insurers roughly $1.4 million in one year.

“The cost savings demonstrated by the Pennsylvania Project should draw the attention of many payers to the value of leveraging pharmacists in the community where their members live to improve health and wellness and reduce overall health care costs,” said co-author Jesse McCullough, PharmD, of Rite Aid Corp., in a press release.