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    The $290 billion pharmacy problem


    Aglaia Panos
    On May 11, U.S. Surgeon General Regina Benjamin and the National Consumers League (NCL) launched "Script your Future," a 3-year national campaign to improve medication adherence [see related article "Coalition launches campaign to educate public about adherence" ]. Formed in response to the extraordinary cost of nonadherence to the healthcare system, the campaign focuses on helping patients with diabetes, COPD, asthma, high blood pressure, and high cholesterol reach better health outcomes.

    The statistics associated with nonadherence are staggering. Research conducted by the New England Healthcare Institute (NEHI) ( http://www.nehi.net/uploads/full_report/pa_issue_brief__final.pdf) reported the cost of nonadherence to be $290 billion per year, almost 10% of the total U.S. healthcare budget.

    A Medicare study published in 2005 reported that 90% of seniors on prescription drugs were using 5 or more drugs, half had more than 1 physician, and one-third used more than 1 pharmacy. A Kaiser Foundation report published in September 2008 stated that of the 3.8 billion prescriptions filled in 2007, only 50% were taken as directed.

    According to a "Script Your Future" statement, "One out of 3 people never fill their prescriptions; more than one-third of medication-related hospital admissions are linked to poor adherence; nearly 45% of the population has 1 or more chronic conditions that require medication; and nearly 3 out 4 Americans don't take their medications as directed."

    Factors contributing to nonadherence are well known. In older people, they often include impaired vision and hearing, forgetfulness, impaired motor skills, loneliness, complexity of medication regimens, confusion, and cost of medications. Another factor for many isolated elderly patients is that they do not have someone to advocate for them.