This may sound familiar if you’ve read any of my blogs previously. It seems that many of these studies on medication adherence focus on Diabetes. Why? While I haven’t done a study on it, it would seem probable that it’s the nature of this chronic disease and it’s corresponding patients. It’s pretty obvious to those of us that are diabetics that the disease should be controllable and preventable. Just look at the nature of the projected growth of the disease. It’s doubled in the past 50 years and it is growing at a faster rate than the population. This disease is obviously caused by eating a less-than-perfect diet choices, including sodas and fast food. We know that exercise is an important component to fighting the disease. We’ve been educated on the subject and we get it. So we are willing to be identified as diabetics so that we can do something to effect a positive outcome. Our blood sugar can be quickly affected by the medications used to combat the disease. We are a bit angry by how slowly the pharmaceutical development system works. We want more from our doctors, pharmaceutical companies and health insurance companies.
The Heath Insurance companies are currently shell shocked. They are having a hard time knowing how to move in one direction or another because they keep being handed new and additional costs for Obama Care. They’re probably attending a whirlwind of seminars telling them how to survive the new spate of expensive laws that are directly related to what they do every single day, so disease control winds up taking a secondary role to their legal compliance.
This latest study, published by Mary Ann Liebert Publishers, using only 188 patients as it’s sample, has surmised that cost reductions on medications and insurance co-pays is a major step forward in controlling their glycemic levels for these diabetic patients. There is, the study suggests, a “… strong association between poor medication adherence, adverse clinical outcomes, and increased overall costs in diabetes and other chronic conditions, increased cost sharing actually may increase overall hearth care costs.”
There are two ways to look at this: Health Insurance is a matter of spreading the costs of healthcare out to a much larger group of somehow similar health care patients. And the more patients in the group the more predictable and manageable the group costs can be amortized by the number of patients… but this assumes that we are actually being included in groups of similar patients. How would a patient know that as this is a function of the actuaries and not health experts, most likely. It is also likely that health insurance organizations are not pairing us with similar medication adherence, but with people of similar age or business categories. Maybe it’s better that we don’t know the details.
The other way is to look at this (and maybe actuaries do this) is to group patients with proven greater adherence than other groups. I believe this would likely achieve better health outcomes and reduce costs to the patients in such a group. This is referred to as VBID (value based insurance design) in the study. I would rather be in a group of patients with similar medication adherence because those patients who are adherent will almost certainly lower the overall costs of healthcare; those patients who are medication adherent are more likely to take a more active role in their own healthcare. If this were the case, insurance companies should be more willing to pay the co-pay for medications and drop much of the annual deductible. Regardless of the chronic condition, if patients are fully adherent, it becomes predictable that all parties, including patients and their health insurance organizations, will save significant savings over groups of patients who are not adherent.