The explosive growth in specialty pharmacy in the last 5 years has had a dramatic impact on drug expenses for hospitals, health systems and managed care organizations. A key concern for specialty pharmacy providers and at-risk organizations alike is patient medication adherence to these prescribed therapeutic agents and regimens. Over the years, new methods and technologies have been developed and evaluated by several providers and payors in the healthcare marketplace in an attempt to improve patient medication adherence rates and, thereby, clinical outcomes. Unfortunately, most if not all of the technologies available in the marketplace today still have not successfully addressed this issue.
Overall patient medication regimen adherence rates are alarming:
- Half of all patients do not take their meds as prescribed (1)
- Adherence is lowest among patients with chronic diseases (2)
- At least 125,000 Americans die annually due to poor adherence (3)
- NEHI estimates that total potential savings from adherence and related disease management could be $290 billion annually, > 13% of ALL health spending (4)
As noted above, patient noncompliance is a significant burden for our healthcare system and can have serious consequences for specialty pharmacies and at-risk organizations. Specialty pharmacies are increasingly being judged by their patient medication adherence rates and adverse drug events. Pharmacies can be at risk for losing their access to the manufacturer’s supply of specialty medications if the rates of medication adherence are too low or the rate of adverse drug events is too high. Further, managed care organizations in particular have hard dollars at risk if their patients are noncompliant. Nonadherence can lead to disease state exacerbations, ER visits and hospitalizations which can put a significant strain on the MCO’s fixed annual financial resources.
A Potential Solution to the Problem
As we all know and likely have experienced personally, changing human behavior is an uphill battle in any endeavor and, thus far, utilizing medication adherence tools is no exception. In addition, changing a behavior or routine can often have unanticipated, undesirable or even adverse consequences. Most commercially available adherence solutions require patients to take action by manually documenting their activity on line or logging into a mobile application on their smart phone. Patients inconsistently perform this additional step, perhaps due to inconvenience or process fatigue and may ultimately abandon it altogether.
The simple solution is to eliminate any change to the patient’s specialty medication preparation and administration routine whenever possible, capture the patient activity passively, and send it to a cloud based database. This is where Audaire Health comes into play.
Audaire’s patient medication adherence solution was built from the ground up with one goal in mind – to create a simple solution to specialty medication adherence documentation that requires no patient behavior change. This pharmacist-designed, patent pending product is an internet connected device installed in the patient’s home. The device sits in the home and utilizes a number of sensors within the box to build a unique patient activity profile and track medication usage. Currently, the device can be utilized with any injectable specialty medication provided in a single or multi dose vial or single use pen. Audaire will be developing additional capabilities in the near future to allow for multiple dose injectable pens and oral medications to be used with the device as well.
Installation takes less than 5 minutes for both patients and providers. The device simply needs to be placed in reasonable proximity (within approximately 10’) to the patient’s usual location for specialty medication preparation and administration. Once the device is setup, there is nothing else the patient must do to make the service work. The patient continues on with their ordinary routine, administering their medication just like they normally do, and that activity is logged via WiFi and immediately sent to an online database. Providers have access to real-time, objective patient adherence data and have the ability to customize alerts for non-compliant patients.
Audaire Health believes this product presents specialty pharmacies and managed care organizations with two unique value propositions:
- Better Patient Data
- Objective (no relying on patient reported data)
- Passively collected (no behavior change needed)
- Real-time (no relying on refill data)
- Immediate Interventions for non-compliant patients
- Timely interventions allow providers the ability to close the feedback loop and change patient behavior faster
Audaire Health is in the middle of initial alpha tests of this technology and is currently enrolling patients taking TNF blockers (Humira, Enbrel, etc.). If you are interested in learning more about this innovative solution or piloting their technology, feel free to contact them at firstname.lastname@example.org.
1 – Brown MT, Bussell JK. Medication Adherence: WHO Cares? Mayo Clinic Proceedings. 2011;86(4):304-314. doi:10.4065/mcp.2010.0575.
2 – Sokol MC, McGuigan KA, Verbrugge RR, Epstein RS. “Impact of Medication Adherence on Hospitalization Risk and Healthcare Cost.” Med Care. Jun 2005;43(6):521-30.
3 – McCarthy R, “The price you pay for the drug not taken.” Bus Health. 1998;16:27-28,30,32-33.
4 – NEHI Research Brief, “Thinking Outside the Pillbox: A System-wide approach to Improving Patient Medication Adherence for Chronic Disease.” NEHI, 2009.