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Nonadherence an alarming trend – Express Scripts Canada 2019 Prescription Drug Trend Report

Express Scripts Canada (CNW Group/Express Scripts Canada)
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Depending on the conditions for which they are being treated, as many as 70 percent of Canadian patients are not taking their medications as directed by their physicians. These statistics are among the key findings of the Express Scripts Canada 2019 Prescription Drug Trend Report: Active Management Critical. Released today, the report highlights a growing concern with patients taking multiple medications because they are the ones deemed more likely to be nonadherent.

“In order for medications to work, they must be taken as directed. Our benefit claims data analysis and other research shows that routinely, patients do not take medications as prescribed. They don’t always finish their prescriptions and they regularly miss doses,” says Express Scripts Canada President Dr. Dorian Lo. “Compounding the problem, the greater the number of health challenges a patient lives with, the less likely they are to take their medications as directed.”

Dr. Lo, a physician who was named President of Express Scripts Canada earlier this year, calls prescription medication nonadherence “a real health crisis” and adds that this troubling trend has multiple negative effects, ranging from worsening health conditions among patients to wasted spending by patients and drug plans.

While nonadherence is a problem for the majority of patients regardless of their treatment needs, it hits patients who take more than one medication particularly hard. The more medications a patient requires, the less likely they are to follow their prescribed medication regimes. Data shows that 44% of patients who take one medication are nonadherent; 58% of patients who take two to three medications are nonadherent; 77% of patients who take four or more medications were deemed to be nonadherent to at least one of their treatments.

Dr. Lo says that a holistic approach to benefit plan design can help turn the tide on nonadherence through timely interventions. “Research tells us that there are many different reasons for being nonadherent, some clinical, some cost-related and some behavioural – so improving adherence requires a highly personalized approach. A ‘one-size-fits-all’ approach does not work.”

Nonadherence data
The more severe and complex a patient’s condition (or conditions) the more likely patients are to not take their medications as directed by their doctor. This is true of:

  • 70% of plan members with asthma/COPD
  • 47% of plan members with cancer
  • 45% of plan members with diabetes
  • 45% of plan members with inflammatory conditions such as rheumatoid arthritis, MS and lupus.

Holistic approach to care offers effective interventions, better health

Express Scripts Canada services help address nonadherence through the following types of targeted support:

  • Channel Management – Express Scripts Canada Pharmacy® drives down costs while delivering optimal patient care, including home delivery of three-month supplies of regularly used drugs for chronic medical conditions, with auto-refill capability.
  • Patient Health Support – Specialized, holistic care helps patients better manage treatment complexity, lowering costs and improving adherence and health outcomes.
  • The Express Scripts Canada Therapeutic Resource CentreSM program offers pharmacy specialists who provide patient-focused consultation, and help patients manage chronic diseases and the medications prescribed for them.

Read the full report.