Does improved medication adherence reduce inpatient hospital expenditures

2017 
Purpose This study aims to assess whether patients [who receive community pharmacy services at locations where routine medication therapy management (MTM) care is reimbursed] who were adherent to their medications generated lower inpatient hospitalization expenses. Design/methodology/approach This is a retrospective, descriptive and cross-sectional study using administrative claims data drawn from 84 community pharmacies in North Dakota. The included patients were enrolled in a Blue Cross Blue Shield of North Dakota insurance plan and were taking one or more of eight groups of medications (metformin, antidepressants, anti-asthmatics, ACEs/ARBs, beta-blockers, calcium channel blockers, diuretics and statins) commonly prescribed to treat chronic conditions filled between July 1, 2014 and June 30, 2015. Community pharmacists used software that allowed the pharmacists to provide and bill for MTM services. Data from these sources were used to calculate medication adherence and inpatient costs. Findings Patients prescribed a beta blocker, a calcium channel blocker, and a diuretic or an anti-diabetic medication, and those who are fully adherent to their medications were associated with significantly lower inpatient hospitalization costs (as measured by insurance payments to hospitals) as compared to non-adherent patients. Patients who were fully adherent to their medications had no statistically significant differences in patient-specific costs compared to non-adherent patients. Originality/value Patients receiving services at a community pharmacy that offers MTM services and those who were adherent to their medication regimens generate lower health care expenses. Most of the savings come from lower hospitalization expenses, rather than patient-paid expenses.
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