Community pharmacists could save Australia $1.9B a year: study


Medication adherence intervention led by pharmacists shows improved adherence rates of nearly 10% over 12 months—or $1.9 billion in healthcare cost savings

A new study has modelled estimated savings from a community pharmacist-led intervention combating medication non-adherence across three prevalent conditions.

Research led by community pharmacist and PhD candidate Rachelle Cutler, from the Graduate School of Health at the University of Technology Sydney, calculated the total national cost of medication non-adherence across hypertension, dyslipidemia and depression in 2018 at $10.4 billion, or $517 per adult in Australia.

Her team then accessed GuildLink pharmacy dispensing data for patients who had received a community pharmacy based educational intervention to enhance medication adherence, as part of the MedScreen Compliance program.

“We looked at their dispensing records and when they came back to get a prescription – say they were coming in for a blood pressure medication – when did they come and collect that medication,” Ms Cutler told AJP.

“Over the 12-month period we averaged it out to see were consistently picking it up every month or not.”

This was calculated as a proportion of the 12-month period—six months before the pharmacist gave the adherence intervention, and six months after that.

Based on their modelled data for 20,335 patients using rosuvastatin, irbesartan or desvenlafaxine, pharmacist intervention improved adherence rates by 9.3% – from 52.3% at baseline to 61.6% – over a 12-month period.

Cost estimates showed this improvement in adherence led to a saving of $95 per adult, reducing the burden incurred by non-adherence in Australia by $1.9 billion (from $10.4 billion down to $8.4 billion, or $421 per adult).

These results show that funding of pharmacist-led services to improve medication adherence will remove wastage and inefficient usage of the current system, explained the researchers—especially important as fears circulate that the current level of health spend is not sustainable.

“Medication adherence is such a big problem. We know that 30-50% of patients don’t take their medication properly,” Ms Cutler told AJP.

“That’s a big cost to the government because it results in unnecessary hospitalisations, GP visits, all of those things.

“If we can address that at the pharmacist level, which we’re quite well equipped to do as part of our training, then it’s definitely a cost saving measure that we can help out in terms of the government’s funding in healthcare.

“Nothing like this [study] in the Australian landscape had ever been done before, so it was nice to be able to quantify this into a figure.”

Pharmacists can help patients to improve adherence by having conversations with them and seeing how they’re going with their medications, she said.

There is also potential for use of technical components, for example apps to help improve adherence, giving them information and skills so they can take control of their own medication behaviours.

“But initially just having conversations with the patients is the first step,” said Ms Cutler.

Funding of medication adherence programs should be considered by policy makers to ease the current burden and improve patient health outcomes moving forward, the researchers conclude.

The research was published in Patient Preference and Adherence.

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5 Comments

  1. Andrew
    27/05/2019

    Could the same outcome be achieved for cheaper by eliminating the need to come to the pharmacy every month?
    Interested to see the modelling where patients taking almost one additional dose per year give a population-level saving of nearly $2b.
    Also, current compliance at just over 50% and peak bodies asking for MORE funding? Get the basics right first.

  2. Andrew
    27/05/2019

    Could the same outcome be achieved for cheaper by eliminating the need to come to the pharmacy every month?
    Interested to see the modelling where patients taking almost one additional dose per year give a population-level saving of nearly $2b.
    Also, current compliance at just over 50% and peak bodies asking for MORE funding? Get the basics right first.

  3. Apotheke
    27/05/2019

    One study over 12 months cannot be extrapolated out like this . This is a totally erroneous conclusion. You need a number of studies and far more robust ones than this one before you can come to any conclusions. How about patient interviews and looking at clinical outcomes not just the number of times items are dispensed by one or more pharmacies (incomplete data set) unless you track individuals by their medicare number.

  4. JimT
    27/05/2019

    “Funding of medication adherence programs should be considered by policy makers to ease the current burden and improve patient health outcomes moving forward, the researchers conclude.”

    Now that’s the kicker !!!!

    This should also put to bed extended repeat intervals and dispense quantities

  5. M M
    27/05/2019

    I could see this as a failure of pharmacists doing their jobs right at each dispense.

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