Health Policy February 25, 2019
Drugs don’t work in patients who don’t take them

By News Feature - Accountable Care Journal

A new White Paper from IQVIA illustrates the cost of waste in the UK from patients not taking the drugs prescribed to them. In terms of diabetes, one of the major health challenges in Britain, this is particularly significant. As many of the implications of not treating this condition are preventable, new solutions must be considered to address the challenge.

More than 30 years after C. Everett Koop famously observed that "drugs don’t work in patients who don’t take them," poor adherence remains a significant barrier to achieving the maximum benefits from medicines — and a key source of waste in the UK NHS.

Building on evidence and experience to date, a new therapy adherence program from IQVIA offers a simple, cost-effective and scalable solution with measurable success. Its compelling results, demonstrated here with diabetes, support its role as a valid tool to help improve efficiency and outcomes by facilitating the optimal use of medicines in a range of primary care diseases.

From incremental advances to scientific breakthroughs, modern medicines offer exceptional potential to improve population health. In the UK, nearly three million drugs are prescribed every day at an annual cost to the NHS of more than £9 billion.

Used appropriately to prevent, cure or manage a range of illnesses, they can significantly enhance quality of life, disease outcomes and longevity. Critical to achieving these goals, however, is adherence to treatment – drugs will only work in patients who take them. A particular example is diabetes in the UK.


What is the UK diabetes challenge?

In the UK, diabetes now affects around 3.8m people. Despite effective pharmacotherapy, successful care delivery remains a challenge, with fewer than 50 per cent of patients achieving recommended glycemic targets. Non-adherence in diabetes has profound implications, exposing millions of patients to serious and preventable cardiovascular disease (stroke, myocardial infarction), visual impairment (leading to blindness), kidney failure (requiring dialysis or transplantation) and limb amputation.

Thus far, approximately 80 per cent of annual NHS spending on T2D (currently in the region of £8.8bn) is attributable to treating these complications. Based on reported rates of non-adherence, IQVIA has estimated that around 7 per cent of this cost – equating to £500m annually – is driven by sub-optimal therapy adherence. Good adherence is associated with a lower risk of complications, mortality and economic burden; health records reveal that adherent T2D patients are 10 per cent less likely to visit hospital and 28 per cent less likely to die than those who fail to take their medication.


Over a 12-month period following the implementation of the Pharmacy Patient Adherence Program, total use of the medicine across more than 80,000 patients increased by 8.6 per cent in participating pharmacies versus 2.6 per cent in non-program pharmacies

This aligns with the plans set out initially in the NHS Five Year Forward View and subsequently in the Long Term Plan to manage chronic and long-term conditions through cooperation between siloed elements of the health and care systems, in some cases through an integrated care system framework. Not only is this model designed to be more patient centred to increase uptake of treatment programmes, it also allows greater collaboration between all healthcare stakeholders to be fostered to improve patient outcomes.

Carol Alexandre, Vice President, Global Key Account Management at IQVIA, said: “Building on our long term partnerships with pharmaceutical companies and pharmacies, IQVIA is well positioned to help implement Pharmacy Patient Adherence Programs that can be cost-effectively embedded into health system processes and significantly impact adherence, disease burden and NHS patient outcomes. ”

Full White Paper can be read here.  


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