Other areas of avoidable costs that the report addressed include medication errors; suboptimal use of generic drugs; delays in evidence-based treatments, which can occur when patients do not receive appropriate screening for conditions like diabetes; and drug mismanagement among older adults, especially those who have multiple chronic diseases.
Improvements have been made to address some of these issues. Generic drug usage, for instance, is on the rise and the percentage of patients who are inappropriately prescribed antibiotics for the cold or flu dropped to 6% in 2012, compared with 20% in 2007.
“We see some positive signs of improvement in some of these areas,” Aitken said.
Of the six categories, medication nonadherence made up the largest avoidable cost with an estimated cost of $105 billion in 2012.
The study reported that while cost was a primary driver of nonadherence in the past, issues such as a patient's lack of information about long-term effects of certain diseases and fear of a drug's side effects also contribute to nonadherence.
”The loss of patent protection of widely used medicines has resulted in the availability of low-cost generic alternatives, making therapy affordable for more patients,” the report said. “The second factor is the growing number of interventions by various healthcare stakeholders and at different junctures of the healthcare system aimed at keeping patients on therapy.”
Aitken later noted that he expects performance-based payment systems and accountable care organizations to aid improvements in the avoidable costs that the report studied.
“The overall movement toward more coordination of care, perhaps as that manifests itself in trying to avoid readmissions … will also have a consequential effect on how well medicine treatment is coordinated between in-hospital and community-based activity when patients are discharged,” he said.
This is the first time that IMS has released a report studying avoidable medication costs.
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