Medication Adherence: Technology’s Role in Improving Outcomes
By Matt Phillion
A lack of prescription adherence has cost the U.S. more than $524 billion a year due to morbidity and mortality, according to the PAN Foundation. Organizations must look for ways to remove barriers to adherence to ensure patients can access the prescriptions they need, including through the utilization of technology platforms.
“There are a lot of reasons for non-adherence. It can be driven by the patient, by the economics of the situation, by the physician interaction and engagement,” says Prasanna Parthasarathy, CEO of Medvantx, which recently announced Insights, a fully integrated, non-commercial pharmacy platform to improve medication and healthcare access across the country.
Medvantx is focused on motivated patients who can’t afford their care, either because of copay situations or access to healthcare in general. “One-third of prescriptions don’t even get picked up,” notes Parthasarathy. “And when you look at refill rates, the statistics are even worse. From a management perspective, that’s an even bigger cliff.”
He continues, “There are multiple things we can do around improvement of adherence in general.” For example, healthcare could make some advances through an app or cloud AI solution; however, those technologies may not be for everyone. “We’ve got to work with the patients where they are,” he says.
The industry also needs to take into account barriers to adherence that have nothing to do with the medications themselves. “For a prescription assistance program, there is a patient population that is 70% women,” according to the National Institutes of Health, notes Parthasarathy. “These patients may be running around dealing with their daily lives, trying to put food on the table. What we need to do is figure out how to make it easy to absorb the information about what they’re taking and provide services and counseling around drug interactions, therapies, and other questions.”
Often, that education role must fall to the pharmacist. “We have access to pharmacists, and that really does help educate the patient relative to what they’re dealing with, both digitally and through other mechanisms,” says Parthasarathy. “If you think about digital health and a post-COVID world, we are dealing with a lot of patients who want to be the quarterback of their own healthcare journey. How do we put information at their fingertips? What are they looking for? How do we partner with patients and physicians to meet their needs and educate them?”
Improving transparency and interoperability
Any system that offers support for medication adherence needs to be prepared to help patients in the ways they need it most, such as multilingual support, enabling licensed pharmacists with the appropriate expertise to connect with patients and ensure they retain and understand information. “We need to make sure we spend enough time on the patient education perspective,” says Parthasarathy.
Simultaneously, there needs to be appropriate interoperability with prescribing systems from the perspectives of the physician, the pharmacy, and regulatory/compliance bodies to provide transparency around medication information. “The analytics should be accessible to the providers and patients. This is an area we’re paying a lot of attention to,” says Parthasarathy.
There are a lot of tech solutions built around medication adherence, including pill dispensers, telemedicine components, and pouch packaging of medication. As technological evolution gains speed, it creates opportunities for patients to get more information more easily. But how do we ensure all these components work together—and who pays for the development of that interoperability?
“There’s a level of complexity we need to overcome as an industry to provide access into multiple sources in a HIPAA-compliant way to enrich the provider with information they need, plus put it into fulfillment of services,” says Parthasarathy. “I don’t think there’s going to be one single answer. But we need to consider the technology, the standards, and the economics.”
To improve medication adherence, economic mechanisms must be in place so that patients are not choosing between medications or food. Prescription assistance programs help address the 13% of the population below the poverty line, but underinsured individuals need help as well, Parthasarathy notes.
Targeted therapies and specialty drugs
The specialty drug market continues to grow rapidly, applying a great deal of data and computing power toward targeted therapies, Parthasarathy notes. These innovations are advancing healthcare and treatment of chronic diseases, but Parthasarathy says it is important that the industry provides platforms to ensure equal access.
“It’s good for society at large to have more pointed therapeutics rather than treating the entire body. The specialty drug evolution has been quite impressive over the last decade,” he says. “It’s helping a lot of people in need, but it’s more expensive than generic treatments, and it’s coupled with inflationary pressures we’re seeing in the recessionary climate as a lot of people are looking for help.”
These aren’t just patients at the poverty line. Family size, minimum copays, and other factors can mean a wider population needs help paying for their medications. “[A person] may be insured but have a $3,000 to $5,000 minimum copay,” says Parthasarathy. “If they’re the breadwinner and they now need to deal with a life-threatening disease and also put food on the table, that’s overwhelming.”
There’s an enormous cost to non-adherence, Parthasarathy notes, and the industry must help patients stay educated and retain access to the medications they need.
“One area that’s a constant is making sure we provide the highest quality of service with reliability and consistency,” says Parthasarathy. It’s also important to stay up to date with regulatory evolution. “Laws are coming up that are driven by environmental changes around the world,” he says. “Particularly in the U.S., some states are hot in the summer months, so we have to deal with more ambient drugs that need to be temperature-controlled than before.”
Organizations working toward medication adherence have an opportunity to help millions of patients across the country in need of access. It’s a daunting task. “I think it’s key to provide and simplify the engagement model across the patient, provider, payer, and pharmaceutical companies—delivering high-quality services at the lowest price,” says Parthasarathy.
There have been advances in digital health tools related to medication adherence, such as Medvantx’s Insights platform. Through these tools, providers can help patients take charge of their health, improve patient access to information, and supply telemedicine options for education and consultation.
“We’re looking at a more digitally savvy population, and they’re armed with a lot of data,” says Parthasarathy. “Their questions are more pointed to the research they’ve done, and they come to us with more specifics about therapy management, drug interactions, and more. That’s where having the right type of person on our end to ensure we meet them where they are, whether they’ve done all the research or none, is so important, so they leave with the information they need to continue their regimen from their doctor.”
As the industry continues to innovate, it must also ensure those most in need are not left behind. “It’s about finding the right balance to make sure we’re simplifying how therapies are managed and delivered, while continuing to innovate and make sure we have the right level of access to care in this new world,” says Parthasarathy.
Matt Phillion is a freelance writer covering healthcare, cybersecurity, and more. He can be reached at matthew.phillion@gmail.com.