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Ignoring doctors' orders on prescription drugs proves costly, CVS reports

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Friday, June 28, 2013, 12:01 a.m.

Pennsylvania could save an estimated $281 million a year in health care expenses if residents did a better job of adhering to prescriptions, says a report released on Thursday by CVS Caremark Corp.

Though Pennsylvanians do a decent job of sticking to doctors' orders, compared with many other states, CVS officials said there's room for improvement.

“Medication adherence is relatively simple, but it can have a big impact,” said Helena Foulkes, chief health care strategy and marketing officer for Woonsocket, R.I.-based CVS.

In addition to its 7,400 retail pharmacies in more than 40 states, CVS manages pharmacy benefits for company health plans and their 60 million members. Using data collected from the companies, it found that 72.5 percent of patients taking drugs for four conditions — diabetes, hypertension, depression and dyslipidemia, a condition in which a patient has high “bad” cholesterol and low “good” cholesterol — follow their prescriptions at an optimal level.

CVS' study was limited to its customers, but experts said drug nonadherence is a costly problem across the country.

“Medications treat conditions, and if people aren't taking their medications, then their conditions are out of control,” said Dr. Scott Drab, associate professor at the University of Pittsburgh's School of Pharmacy.

Non-adherence to prescriptions costs the health care system $100 billion to $289 billion a year in unneeded spending, because patients who don't take medications get sicker and end up back in the hospital or doctor's office, according to a study published last year in the Annals of Internal Medicine.

A person with diabetes or hypertension might not feel different after stopping medications, but the diseases will worsen and cause serious problems later, Drab said.

“Those long-term complications are much more costly to treat and often require hospitalization,” Drab said.

About one-third of Americans stop taking prescription drugs at some point after the first refill, Foulkes said. One-quarter of new prescriptions never get filled.

“It's shocking how poor Americans are at taking their medicines,” she said.

Drab cited several common reasons why patients stop, or never start, taking drugs, including costs, a breakdown in communication between doctor and pharmacy, and patients thinking they don't need the drugs.

“We know it's a widespread problem,” he said. “We know there are things we need to do better.”

One big deterrence is cost, and having cheaper generic versions available is a key to improving adherence, Drab said.

CVS agrees and is pushing for greater access to generic drugs. The study estimates Pennsylvania could save $734 million a year by converting brand-name drug prescriptions to generics when available.

“Pennsylvania is at over $1 billion in savings if you could get people to the optimal level (of adherence) and if you get them to use generic medications,” Foulkes said. “Consumers on generics are more likely to stay on their medications.”

Alex Nixon is a Trib Total Media staff writer. Reach him at 412-320-7928 or

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