PhRMA Value of Medicines 062712
 

PhRMA Value of Medicines 062712

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PhRMA Value of Medicines 062712 PhRMA Value of Medicines 062712 Presentation Transcript

  • Medicines Play a Key Role in ImprovingHealth While Reducing Avoidable Costs Pharmaceutical Research and Manufacturers of America
  • OverviewProper medication adherence lowers overall healthcare costs due to offsets in related costs(i.e., hospitalization, emergency care visits)Poor medication adherence = higher Proper medication adherence savesoverall healthcare costs patients money on healthcareResearch shows that treatment gaps and Potential cost savings from appropriatelack of adherence to physician-prescribed use of medicines can be significant,medications lead to higher spending on especially for the growing number ofotherwise avoidable medical care. Americans with chronic health conditions. Prescription medicines play a key role in: • Maintaining health • Reducing mortality • Preventing emergency room visits/hospitalizations • Improving worker productivity Pharmaceutical Research and Manufacturers of America
  • How does access and adherence to medicinesaffect health outcomes and medical costs?
  • Medicare Part D Improves Access to Medicines & Lowers Costs Medicare Part D has increased access to medicines for patients while lowering out-of-pocket costs. Part D coverage has led to spending reductions in Medicare for hospitals and nursing homes. Pharmaceutical Research and Manufacturers of AmericaRead More: J.M. McWilliams et al. “Implementation of Medicare Part D and Nondrug Medical Spending for Elderly Adults With Limited Prior Drug Coverage.” Journal of theAmerican Medical Association, July 27, 2011.
  • Prescription Medication Use Reduces Hospitalization Costs According to a 2009 study, adherent use of prescription medicines significantly reduced Medicare spending for inpatient hospitalizations. Study authors say their finding “suggests that drugs are not only cost-effective but actually save money for Medicare beneficiaries.” Key Medication Adherence Facts: • Each additional prescription drug fill reduces hospital costs by about 0.5% (when measured at the mean level of Medicare payments in 2000) • The average cost of beneficiaries experiencing at least one inpatient hospitalization in 2000 was $10,425 per person hospitalized Pharmaceutical Research and Manufacturers of AmericaRead More: B.C. Stuart et al. “Assessing the Impact of Drug Use on Hospital Costs.” Health Services Research, February 2009.
  • Access to Medicines Results in Significant Medicare Savings A recent Harvard study in JAMA found that Part D saves . Medicare about $1,200 per year in hospital, nursing home and other costs for each senior who previously lacked comprehensive prescription drug coverage. According to other experts, this finding led to overall savings to Medicare of $13.4 billion in 2007, the first full year of Part D. This represents more than one quarter of Part D’s total cost during that time. Key Access to Medicines Facts: • Medicare beneficiaries with little to no prior drug benefits increased their use of medicines after enrolling in Part D • Part D enrollees in this category increased monthly drug spending by $27, but decreased overall monthly medical spending by $46 Pharmaceutical Research and Manufacturers of AmericaRead More: C.C. Afendulis and M.E. Chernew. “State-Level Impacts of Medicare Part D.” American Journal of Managed Care, October 2011 Supplement.http://jama.jamanetwork.com/article.aspx?articleid=1104150
  • Medication Adherence Lowers Overall Patient Costs Even though patients who adhere to their medication schedule spend more on prescription medicines, additional spending is more than offset by substantial reductions in spending on other medical care. Adherence can lead to significant reductions in emergency department visits and inpatient hospital days for patients with four chronic conditions.* Pharmaceutical Research and Manufacturers of America * Congestive heart failure, hypertension, diabetes and dyslipidemiaRead More: M.C. Roebuck et al. “Medical Adherence Leads to Lower Health Care Use And Costs Despite Increased Drug Spending.” Health Affairs, January 2011.
  • Medication Adherence Leads to Lower Overall Healthcare Costs How does adherence lower costs for hypertension? Highly adherent patients with hypertension have substantially lower total healthcare costs than non-adherent patients, and costs increase as adherence decreases. Pharmaceutical Research and Manufacturers of AmericaRead More: D.G. Pittman et al. “Antihypertensive Medication Adherence and Subsequent Healthcare Utilization and Costs.” American Journal of Managed Care, August 2010.
  • Medication Adherence Leads to Lower Overall Healthcare Costs How does adherence lower costs for cardiovascular disease? Commercially insured patients with high rates of adherence to statins had significantly lower healthcare costs and lower risks of cardiovascular disease. Pharmaceutical Research and Manufacturers of AmericaRead More: D.G. Pittman et al. “Adherence to Statins, Subsequent Healthcare Costs, and Cardiovascular Hospitalizations.” American Journal of Cardiology, June 2011.
  • Medication Adherence Leads to Lower Overall Healthcare Costs How does adherence lower costs for diabetes? For diabetes patients, a high level of medication adherence is associated with lower disease-related medical costs. Cost of Diabetes Pharmaceutical Research and Manufacturers of AmericaRead More: M.C. Sokol et al. “Impact of Medication Adherence on Hospitalization Risk and Healthcare Cost.” Medical Care, June 2005.
  • Medication Adherence Leads to Lower Overall Healthcare Costs Proper use of diabetes medicines significantly reduces the risk of disease-related complications. In 2011, better adherence to diabetes medicines resulted in significantly lower Medicare spending on hospital and physician services, and these savings exceeded the estimated cost of the drugs. Pharmaceutical Research and Manufacturers of AmericaRead More: T.B. Gibson et al. “Cost-Sharing, Adherence, and Health Outcomes in Patients with Diabetes.” American Journal of Managed Care, August 2010.
  • Poor Adherence Leads to Undesirable Outcomes How does adherence lower costs for osteoporosis? Proper adherence to osteoporosis medicines greatly reduces medical costs, particularly hospitalization and long-term care costs. Similar results were seen for Medicare Advantage enrollees with low levels of adherence. Key Osteoporosis Facts: • Osteoporosis fractures alone cost an estimated $19 billion in 2005, and are projected to cost $25 billion by 2025 • Highly compliant patients cut their risk of fracture by 25% • Patients with highest rates of adherence spent $1,273 less on total medical costs on average Pharmaceutical Research and Manufacturers of AmericaRead More: R. Halpern et al. “The Association of Adherence to Osteoporosis Therapies with Fracture, All-Cause Medical Costs, and All-Cause Hospitalization: A RetrospectiveClaims Analysis of Female Health Plan Enrollees with Osteoporosis.” Journal of Managed Care Pharmacy, January/February 2011.
  • Capping Prescription Coverage Has Little Effect on Total Health Care Costs Seniors with a $1,000 benefit cap under Medicare+Choice were less likely to use medicines appropriately and experienced unfavorable clinical outcomes, including death, according to a NEJM study. Savings from lower use of medicines were almost completely offset by increases in hospitalization and emergency care costs. Pharmaceutical Research and Manufacturers of AmericaRead More: J. Hsu et al. “Unintended Consequences of Caps on Medicare Drug Benefits.” New England Journal of Medicine, June 1, 2006.
  • Appendix: SourcesSlide 4J.M. McWilliams et al. “Implementation of Medicare Part D and Nondrug Medical Spending for Elderly Adults With Limited Prior Drug Coverage.” Journal of theAmerican Medical Association, July 27, 2011.Slide 5B.C. Stuart et al. “Assessing the Impact of Drug Use on Hospital Costs.” Health Services Research, February 2009.Slide 6C.C. Afendulis and M.E. Chernew. “State-Level Impacts of Medicare Part D.” American Journal of Managed Care, October 2011 Supplement.Slide 7M.C. Roebuck et al. “Medical Adherence Leads to Lower Health Care Use And Costs Despite Increased Drug Spending.” Health Affairs, January 2011.Slide 8J. Hsu et al. “Unintended Consequences of Caps on Medicare Drug Benefits.” New England Journal of Medicine, June 1, 2006.Slide 9D.G. Pittman et al. “Antihypertensive Medication Adherence and Subsequent Healthcare Utilization and Costs.” American Journal of Managed Care, August2010.Slide 10D.G. Pittman et al. “Adherence to Statins, Subsequent Healthcare Costs, and Cardiovascular Hospitalizations.” American Journal of Cardiology, June 2011.Slide 11M.C. Sokol et al. “Impact of Medication Adherence on Hospitalization Risk and Healthcare Cost.” Medical Care, June 2005.Slide 12T.B. Gibson et al. “Cost-Sharing, Adherence, and Health Outcomes in Patients with Diabetes.” American Journal of Managed Care, August 2010.Slide 13R. Halpern et al. “The Association of Adherence to Osteoporosis Therapies with Fracture, All-Cause Medical Costs, and Pharmaceutical Research and Manufacturers of AmericaAll-Cause Hospitalization: A Retrospective Claims Analysis of Female Health Plan Enrollees with Osteoporosis.” Journal ofManaged Care Pharmacy, January/February 2011.