Because drugs only work when you take them (and take them correctly)

In our business, there’s a lot of focus on new, high-cost drugs. We even have a “watch list” to be prepared when they hit the market. Yet the beneficial effects of every drug we manage depend on adherence to the prescriber’s directions. And, on average, only half of Americans take their drugs as prescribed.1

Through the hype — Prime keeps the focus on the member

With the approval of PCSK9 inhibitors, Prime analyzed claims data of three million members who were continuously enrolled for four years to better understand high cholesterol and statin use. The results were far more newsworthy than the PCSK9 inhibitors price tag.

80 percent of people with established cardiovascular disease significantly underuse statins:

  • 1.8 percent of the three million had established cardiovascular disease
  • Only one in five of these members were using a high dose statin — AND were taking it regularly
  • Only one in four had tried a second statin during the four years analyzed

From side effects or high cost to simply forgetting to get a refill, the cost of nonadherance is estimated at $105 billion in avoidable expenses.2

What we bring to the table — Adherence Matters™

Adherence Matters is a solution — tailored programs that tackle adherence barriers, helping your employees take medicine as prescribed. See Adherence Matters programs for ASOs.

We target costly, prevalent chronic conditions. Examples include high blood pressure, diabetes, high cholesterol and multiple sclerosis. And this approach can lead to improved member health and a lower cost of care. 

Under the hood — program options at a glance

Adherence Matters program options can be tailored to your needs. Each product and opportunity within the solution helps to optimize adherence, including:

  • GuidedHealth® — delivering actionable information. GuidedHealth identifies drug therapy opportunities and reaches out to plans, members and their doctors to improve care and lower total costs.
  • 90-day supplies — with more choices. Providing 90-day supplies of long-term medicines helps improve adherence, which helps decrease medical costs.3 Prime makes it easier with PrimeMail home delivery and an extended supply network.
  • Prime Therapeutics Specialty Pharmacy™ — proven to increase adherence. Coordinated care, specialized education and 24/7 access to experts helps improve adherence, safety, outcomes — and satisfaction — for members taking critical specialty medicines.4

Prime helps connect key stakeholders across the spectrum of care, all focused on improving adherence for the member. Strategies include value-based benefit design, clinical solutions and network management — all working to drive up adherence and drive down overall costs.

1 Partnership to Fight Chronic Disease. (2009). 2009 almanac of chronic diseases. Retrieved from http://www.fightchronicdisease.org/sites/fightchronicdisease.org/files/docs/2009AlmanacofChronicDisease_updated81009.pdf>.

2 IMS Institute for Healthcare Informatics. (2013). Avoidable costs in U.S. healthcare: The $200 billion opportunity from using medicines more responsibly.

3. Lassen, D. and M. Hermes. “Solving the Medication Adherence Puzzle.” Benefits & Compensation Digest. October 2010.

4. Prime Specialty Pharmacy Member Survey- Analysis of Satisfaction and Adherence 2014.

 

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