How to decrease the cost of employee benefits: Medication management

One of the fastest growing expenses for employers today is employee medical benefit costs. There are many reasons for this: the rising cost of health care, changes in lifestyle, the obesity epidemic, increasing chronic disease burden, among other factors. Employers have expended a great deal of money trying to curb rising employee benefit costs.

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Focusing in on medication management in employee populations represents a viable strategy to improve population health while reducing overall healthcare expenditures. Typically one hears about drug formulary management as a tool to decrease the cost of employee benefits, which is of course an important component to manage expense. However, this does not improve population health. There are other issues at play when considering efficient use of resources. For example, let’s consider a patient that’s written a prescription by their PCP to decrease their blood sugar and treat diabetes. This medication has the potential to keep the person healthy – preventing complications like kidney disease, neuropathy, heart disease, and vision problems, to name a few.

But that medication will only work if:

  1. The prescription is filled and picked up at the pharmacy.
  2. The person can afford to pay for the medication.
  3. The person takes the medication as prescribed on a daily basis (adherence).

Focusing on creating healthier people will lead to healthcare savings, especially in populations with heavier disease burden.3 Between $100 and $300 billion of avoidable health care costs have been attributed to medication non-adherence in the US annually, representing 3% to 10% of total US health care costs.1,2 Therefore, it makes monetary sense to support strategies to increase medication adherence, both for the employee and the employer.

Pharmacists are expertly trained to provide medication consultation services targeted to improve patient outcomes. Specifically, medication therapy management (MTM) is a service typically provided to a patient with multiple disease states and a complicated medication regimen. The pharmacist performs a full review of the patient’s medication profile and conditions while providing patient-centered education. Any problems identified, such as drug interactions, drug related side effects, barriers to access, missing drug therapies, and medication adherence problems are addressed in a collaborative fashion and a plan is made to resolve each issue identified. The pharmacist then follows up with providers as needed and may also help coordinate needed care services. Studies have shown that the return on investment on pharmacist led MTM and adherence services is up to 12:1.

MTM has the potential to improve patient health outcomes by providing targeted interventions to patients at the highest risk of medical complications. People who live with multiple medical problems are more likely to struggle with the management of their health, especially if their health literacy is low. Providing a forum for these patients to ask questions about their medications, receive training on how to use medication delivery devices such as insulin pens, inhalers, and nebulizers, and to discuss cost-saving opportunities with a clinical pharmacist can significantly improve health outcomes.

For more information on how you can offer clinical pharmacist services as a part of your employee health benefits package, schedule some time to chat with us now!

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If you found this helpful, you may want to check out the following:

New Year, New Prescription Insurance: What do I need to know?
5 Key Steps to Better Manage Your Health

References:

1.  IMS Institute for Healthcare Informatics Avoidable costs in US health care. 2013. Available at:http://www.imshealth.com/deployedfiles/imshealth/Global/Content/Corporate/IMS%20Institute/RUOM-2013/IHII_Responsible_Use_Medicines_2013.pdf.

2. Benjamin RM. Medication adherence: Helping patients take their medicines as directed. Public Health Rep. 2012;127(1):2–3. [PMC free article] [PubMed]

3. Iuga AO, McGuire MJ. Adherence and health care costs. Risk Manag Healthc Policy. 2014;7:35–44. doi: 10.2147/RMHP.S19801. https://dx.doi.org/10.2147/RMHP.S19801. [PMC free article] [PubMed]

Author avatar
Kristen Engelen, PharmD
Kristen Engelen, PharmD, is the chief pharmacy officer of RxLive and a certified consultant pharmacist; she has over a decade of experience in retail pharmacy settings. Kristen became an RxLive co-founder because of her passion for geriatric pharmacy, with a focus on the intersection of pharmacy and aging.