More than a year after scientists identified the first cases of COVID-19, infection rates continue to rise in regions across the United States.
The virus has been particularly devastating for those who can afford it least: the elderly, underserved communities, low-income families, and people of all ages with chronic conditions.
COVID-19 infection, hospitalization, and death rates for these groups are dramatically higher than for other populations.
According to the CDC, eight out of ten reported COVID-19 deaths in the US are among individuals 65 or older. And data from the COVID Tracking Project reveals that Black or African American individuals are up to 1.5 times more likely to die from COVID-19 than white patients.
Patients with multiple chronic diseases are also at elevated risk. The CDC cites chronic kidney disease, COPD, obesity, and heart conditions as known contributors to poor outcomes from COVID-19, while Medicare statistics show extremely high rates of hypertension and hyperlipidemia, diabetes, and chronic kidney disease among hospitalized beneficiaries.
All these groups have another major risk factor in common. They are the populations that most often struggle to cope with the social determinants of health (SDOH), such as food security, social isolation, and access to healthcare, living wage employment, and transportation.
In the current economic environment, many of these individuals are even facing the hard choice of prioritizing food and shelter over the expenses of necessary healthcare and medications, despite the knowledge that avoiding care may increase their vulnerability to their preexisting conditions – and subsequently raise their chances of experiencing a worse outcome if they contract COVID-19.
Even with the prospect of mass vaccination on the horizon, it’s more important than ever for healthcare providers and health plans to understand and address the social determinants of health, starting with ensuring pharmacy access and medication adherence.
The role of medication adherence in population health management
Population health management focuses on staying one step ahead of the clinical and non-clinical factors that may lead to poor outcomes in targeted patient groups. For the six in ten Americans with at least one chronic disease, medication adherence is a critical component of maintaining good health.
Suboptimal medication adherence has significant impacts on chronic disease management and overall wellbeing. Incorrect use of medications contributes to tens of thousands of preventable deaths and half a trillion dollars in healthcare waste every year.
The reasons behind medication adherence issues are varied and challenging. Some patients experience undesirable side effects and change their doses without consulting their physicians, while others struggle to understand the importance of their prescriptions or fit their medications into their daily routines.
For patients with socioeconomic difficulties, the problem gets even more complex. Out-of-pocket drug costs are skyrocketing, leading large percentages of patients to abandon their medications unwillingly.
By Kim Huynh and Esther Ketelaars, health and life sciences experts, PA Consulting.
Studies unanimously show the negative effects medication non-adherence has on clinical outcomes and healthcare costs. Adherence is critical to ensure that medications work properly and important for pharmaceutical companies because it helps keep their drugs covered under health plans. Healthcare insurers want to ensure their covered drugs are treating their members effectively and are seeking to prevent more costly health care.
So, while traditionally medical adherence solutions have been paid for and promoted by pharma and payors, a new player has a chance to enter the scene and challenge the status quo. Now is the time for providers to proactively address medication adherence as they start to bear more financial risk through value-based care models.
How can providers play a larger role?
Provider organizations who focus on medication nonadherence have a great opportunity to improve patient outcomes and support their value-based care models. According to the Center for Disease Control medication nonadherence results in 10% of hospitalizations and 125,000 preventable deaths in the U.S. each year. Likewise, low medication adherence leads to treatment failures between 30% and 50% of the time.1 These negative impacts become even more relevant to providers as patient outcomes continue to be more closely tied to reimbursement and payment incentives.
Pharmaceutical companies, payors, some providers, other consumer-focused companies in the healthcare value chain, and even governments have tried to address nonadherence. With the recent growth of digital health solutions especially, many have focused on leveraging novel technologies. However, there are a myriad of reasons for patients not compliant with their medication and adopting a single tool or technology has rarely been effective in reducing nonadherence.
A one-size-fits-all approach will often only address a single issue for a limited number of patients. With their direct access to patients, providers have a better chance of addressing the complex mix of reasons for nonadherence and design medication adherence programs customized to each patient. Personalized intervention plans invite a direct solution to each patient’s reasons for nonadherence with the appropriate tools that address the underlying cause for that individual.
Developing such a program requires factoring in root causes and reasons for nonadherence, using predictive analytics to identify high-risk patients, and gathering a diverse set of interventions to address those root causes. The position and shared decision-making power between providers and consumers indicate that providers can address medication adherence for more patients, improve patient outcomes, and reinforce value-based care.
Designing a patient-centered medication adherence program
Many of the tried and tested programs have been designed based on an assumption of the underlying reason for nonadherence. However, for these programs to be truly effective provider organizations need to understand and diagnose the patient’s reasons for nonadherence and tailor their intervention with the right tools.
Understand the reasons for medication nonadherence
Exploring the factors contributing to nonadherence allows organizations to understand the inherent complexity of nonadherence. Most interventions fail to produce the desired results because they don’t consider the many contributing factors. The reasons for nonadherence go beyond simple forgetfulness. Only 30% of patients cite forgetfulness as the cause of their nonadherence.
Vaica is helping to solve the hundreds of billion dollar, global medication nonadherence problem with digital, medication management and adherence solutions.
Vaica helps get people to take their medications as prescribed — pills, liquids, inhalations, injections, etc — with precise patient support that optimizes medication adherence.
All of Vaica’s founders, including Tomer Gofer, its current CEO, started off in a different company that developed smart cabinets for medication dispensing in hospitals and addressed the medication adherence problem, as well as medication errors in the hospital environment. After a few years they realized that the true and more complex problem is actually at home, when the patient is suddenly left alone and is expected to cope with multiple medications, confusing prescriptions and absolutely no support. From that point they decided to address the bigger problem and find a solution that focuses on making it possible for even the most complex patient to take their medications as prescribed and lead independent lives at home.
Vaica’s distinctive solution includes a software/hardware combination that ensures accessibility to both patient and caregiver, the possibility to customize a product to the requirements of any therapeutic area as well as a particular patient’s needs and real-time notifications sent to select caregivers if a dose is missed in order to empower a relevant, proactive intervention. Vaica’s solutions have been tested at 15-world class medical centers, reporting a 92 percent to 98 percent success rate. Vaica’s solutions are commercially available worldwide.
Vaica market opportunity focuses on three main segments: pharmaceutical companies, specialty pharmacies and Payers.
Specialty pharmacies are a rapidly growing segment. Medication adherence and patient education is right at the core of the specialty pharmacy operation. This new care standard drives specialty pharmacies to provide services beyond the ones that are typically provided at the retail level. In 2014, it was estimated that retail, mail, and specialty pharmacies dispensed about $78 billion in specialty pharmaceuticals in the US.
Different payers such as health plans and self-insured employers, are a main focus for medication adherence technologies due to their will to prevent complications that result from medication non-adherence and come with great cost.
Who are your competitors?
We have competitors, such as different adherence apps or dispensing devices that are available in the market. We compete over similar segments, but none offer a complete end to end solution that includes software, physical devices and customization.