The $290 billion pharmacy problem
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.