Why Compliance for Life?

“Dr. Edward C. Rosenow III of the Mayo Clinic College of Medicine calls compliance 'the sixth vital sign,' as important as respiration, heart rate, temperature, blood pressure and pain in evaluating a patient's medical status. In most cases, the problem revolves around a failure to take medication as prescribed. This can mean taking too much of a drug as well as too little or none at all. The misuse or nonuse of prescribed medications is estimated to add nearly $200 billion a year to the cost of medical care.”  

(Reported by Jane Brody, Just What the Doctor Ordered? Not Exactly, The New York Times, May 9, 2006)

 

It took only one month after leaving the hospital for one out of eight heart-attack patients to quit taking the lifesaving drugs prescribed to them, a study of 1,521 patients found. The heart patients who stopped taking three proven drugs -- aspirin, beta blockers and statins -- were three times more likely to die during the next year than patients who stayed on the drugs. The study didn't examine why people stopped taking their medicine, but the patients who quit were more likely to be older, single and less educated.


(Impact of Medication Therapy Discontinuation on Mortality After Myocardial Infarction, P. Michael Ho, MD, PhD; et al., Archives of Internal Medicine, Vol 166 No. 17, September 25, 2006, 1842-1847)

 

For diabetes, the average incremental drug cost for a 20% increase in drug utilization is $177 and the associated disease-related medical cost reduction is $1251, for a net savings of $1074 per patient (an average ROI of 7.1:1). For cardiovascular conditions, the average ROI for a 20% increase in drug utilization is 4.0:1 (hypertension) and 5.1:1 (hypercholesterolemia)...Although drug costs are a relatively small fraction of total healthcare costs for [diabetes, hypertension, and hypercholesterolemia], they have high leverage - a small increase in drug costs (associated with improved adherence) can produce a much larger reduction in medical costs. Because these benefits derive from improved adherence, greater attention should be devoted to educating patients on the value of their drug therapy and motivating behavior changes that improve adherence.


(Impact of Medication Adherence on Hospitalization Risk and Healthcare Cost, Sokol, Michael C. MD, MS; McGuigan, Kimberly A. PhD; et al. Medical Care, vol 43(6) June 2005 551-530)