(1007) Impact of a Clinical Pharmacist-led Medication Adherence Program on Medication Adherence Performance, Chronic Disease Control Measures, and Cost Savings

Objectives: The primary objective of this study was to evaluate the medication adherence performance, disease control measures, and cost savings for patients following implementation and utilization of a nationwide pharmacy-driven service focused on improving medication adherence. The Centers for Disease Control and Prevention list chronic diseases as the leading causes of death and disability in the United States (U.S.). Furthermore, chronic diseases are the leading drivers of the U.S. $4.1 trillion annual health care expenditures. Clinical pharmacists can lead teams and leverage technologies to optimize health outcomes and provide cost savings for patients with chronic diseases through improving medication adherence.

Methods: This was a multicenter, retrospective, quasi-experimental evaluation of patients from Central Texas over a 24-month period. This clinical pharmacy-driven service focuses on improving medication adherence in patients with chronic disease states through artificial intelligence-supported analytics, individual case review, and pharmacist-led patient outreach. Medicare Advantage Star Quality and pharmacy claims data were utilized to drive patient segmentation to close medication-related gaps. The primary endpoint was to evaluate if implementation of this pharmacist-led medication adherence program improved medication adherence performance within three medication-related measures: medication adherence for cholesterol (MAC), medication adherence for diabetes (MAD), and medication adherence for hypertension (MAH). Medication adherence was defined as the proportion of days covered (PDC) ≥ 80% of the time in their measurement period. The secondary endpoints included evaluating reductions in select chronic disease control measures (hemoglobin A1c) and cost savings (measured per member per year, PMPY). Descriptive statistics were utilized for analysis.

Results: The medication adherence program was deployed and evaluated in a total of 10,477 patients. Of the total population, 60.6% were in ≥ 1 medication-related measure that generated 2,762 actionable adherence gaps throughout the performance year, with direct closure of these gaps occurring in 47.3% of cases. Medication adherence increased in all three medication-related measures (MAC: 84.8% to 92.7%, MAD: 82.6% to 89.0%, MAH: 86.1% to 92.0%). Specifically evaluating the diabetic adherence population, there was a strong improvement in hemoglobin A1c control (75.5% to 81.7%). Furthermore, the pharmacist-led medication adherence program led to cost savings in each disease-related measure for those patients with PDC ≥ 80% (hyperlipidemia: $2,710 PMPY, diabetes: $3,388 PMPY, hypertension: $3,030 PMPY).

Conclusions: Clinical pharmacist-driven services can be leveraged to increase medication adherence for patients with chronic diseases, while improving disease control measures and reducing healthcare expenditures. Further research should evaluate the relationship of pharmacist-driven services with other factors, such as potential reductions in acute care encounters.