Medication non-compliance is a massively expensive and stubbornly persistent problem for the healthcare industry. Depending on the source you select and the data it uses, non-adherence is estimated to cost the U.S. health system between $100 billion and $300 billion per year.
That’s a staggering number, not to mention one which still defies the efforts of many health leaders. Many vendors have focused on straightforward responses, such as reminders urging patients to take their meds and programs offering incentives to patients who take their meds properly and on time. According to at least one study, however, such efforts haven’t had much of an impact.
However, while there’s no one answer to this problem, a few HIT related solutions are turning up that seem to offer some good ideas for tackling the issue.
One such vendor, Welltok, has developed an approach mashing up patients’ clinical data with its own proprietary consumer database, which includes social determinants of health information. The vendor uses this combination of inputs to predict which individuals are at risk for non-compliance, along with those most likely to refill prescriptions with a reminder. (By the way, I’m aware that other vendors offer similar solutions, but I’m focusing on this one in the interests of clarity.)
Having picked out potentially both non-compliant patients, as well as targeting those susceptible to reminders, Welltok begins its program. Patients who seem prone to changing their refill behavior get contacted via their favorite channels, such as email, text and automated voice.
Welltok isn’t doing this just to make patients and doctors happy. In addition to its med adherence programs, it offers several other services, including formulary options and operational efficiency programs. Its core customers are pharmacy benefit managers, retail pharmacies and specialty pharmacies.
Maybe this is just a prejudice, but my hunch is that it’s better for patients over the long term when med adherence programs are coming from providers rather than competitors in or allied with the pharmaceutical business. As much as pharmaceutical industry players would like us to believe that their goals are aligned with providers’ goals, I would tend to doubt it.
After all, while providers are primarily focused on bettering patient outcomes directly, pharma industry players (at best) make their business by keeping medication purchase levels from tanking. While there’s nothing wrong with getting patients to comply with their med regimen, it’s not clear to me how much benefit such programs can deliver if they aren’t addressing patients’ overall needs.
Still, all of that being said, I do like the idea of Welltok’s leveraging data from multiple sources to understand and predict patient behavior. Yes, it’s unusual to see predictive analytics programs include consumer data, but I’d like to see this happen more often.