Helping Employees Adhere to Medication Schedules: Good for People and Business

Poor medication adherence affects employees and the business. Poor medication adherence leads to poor health outcomes, which in turn costs the business productivity and increased health costs.
— By Kim Persaud

The consequences of employees failing to comply with their prescribed medication schedules are severe for them and costly for employers. Employee health conditions are likely to worsen, leading to higher health care costs and absenteeism, and lower productivity. It seems paradoxical at first glance, but when employees fail to take their medications, especially for chronic diseases, the cost of pharmacy benefits are likely to rise. The reason is that people often get sicker, end up in the emergency room or hospital, and require more powerful and expensive medications and more frequent physician visits upon release.

Employers can play an important role in helping their employees find solutions to medication non-adherence, whether intentional or through absentmindedness. When employees consistently take their medications, the U.S. health system, individuals and the employer benefit.

Non-Adherence Leads to New Medical Issues
The statistics on medication non-adherence are grim.

In 2012, The Annals of Internal Medicine reported the cost to the U.S. health system of non-adherence to medications ranged from $100 billion to $300 billion annually. These costs include utilization of medical resources due to treatment failures and new medical problems that arose from people not taking their medications as prescribed. The researchers updated their figures in 2016, and the estimated annual cost of prescription drug-related morbidity and mortality from nonoptimized medication therapy was $495.3 billion to $672.7 billion.

CDC research found that hospital admission rates increased by up to 69 percent for people with chronic illnesses who are medication non-adherent. Fifty percent of people with chronic illnesses stop taking their medications within the first year they are prescribed.

For employers, this all adds up to higher operational costs. One study in the New England Journal of Medicine found that medication non-adherence led to two to 10 days of absence each year for each employee.

Employees who fail to follow their medication schedules are likely to experience worsening or more severe symptoms, new medical problems, more sick days, leave of absence due to disability, and an inability to be fully productive. They also have a higher risk of injury to themselves or others because people who do not feel good are not as attentive. Employers can expect higher medical costs, including for pharmacy costs.

Not a Simple Challenge to Overcome
It seems so simple: Take the medications as instructed. But it is not that simple for many employees.

Even with pharmacy benefits, there are sometimes high co-pays or lack of coverage for specific medications. Affordability becomes an issue, especially when someone is taking multiple drugs.

Another possible reason is that an individual does not like one or more effects of the medication. The side effects may be unpleasant, or there are drug interactions.

Sometimes people just forget to take their medications or keep forgetting to refill the prescription at the pharmacy.

A common problem is someone who takes their medication for a while, feels better and stops taking it. They just do not understand how the medication works, how it is helping, and why it is important to continue taking it. There are people who are just fearful of taking drugs, especially when they are powerful medications for treating chronic diseases.

Yet another reason is poor communication between an employee and the person’s healthcare provider. Low health literacy about their medical condition and the need for the medication can lead to non-adherence.

Myriad of Employer Solutions
Barriers to medication adherence are varied and complex, so the solutions to overcome them must be varied, too.

One of the first steps is determining if it is possible to reduce costs for pharmacy benefits by working with a pharmacy benefit manager. Often, the employer has already spent considerable time developing the best pharmacy benefit plan possible within the company’s budget.

There may be ways to eliminate co-pays for common medications for chronic diseases to reduce employee out-of-pocket expenses. Another option is implementing a Value-Based Insurance Design (VBID) program that builds consumer financial incentives into premium contribution structures or into plan design benefits. The goal is to drive desired behaviors by helping people make high-value decisions. These are the decisions that are most likely to have a direct positive impact on health outcomes.

Another approach is to include state-of-the-art pharmacogenetic solutions to the benefits package. For example, GenXys offers PGx testing which determines the best match between an employee’s genetic makeup and medication options in order to tailor drug options and dosages. UnitedHealth Group and Sun Life Financial are covering these kinds of tests for specific medical conditions. This approach reduces the occurrences of medications that cause new medical issues and the cost of trial and error.

Yet another strategy is to give employees access to a dedicated pharmacist. This enables the pharmacist to facilitate communication between the pharmacy and health providers, and the pharmacy and employee.

The complexity of medication adherence is more manageable today due to the availability of technologies.
Premise Health offers an onsite pharmacy solution which includes access to electronic health records, easier access for employees who need prescriptions filled or refilled, and a pharmacist that knows the organization’s benefits inside and out. A similar approach is giving employees access to case managers who work one-on-one with employees on medication programs coupled with lifestyle counseling.

One of the critical employer strategies is improving employee knowledge of the importance of adhering to medication schedules. Education can include a website-based e-learning course that employees are rewarded for completing. The health insurance provider may be able to provide experts to hold seminars, in-person or via webinars, that enable in-house and remote employees to attend. The employer can produce newsletters and post positive messages on the intranet social media sites.

The complexity of medication adherence is more manageable today due to the availability of technologies. For example, there are numerous medication reminder apps employees can download that protect their privacy while alerting them when it is time to take a prescription pill. Software is available too that will send prescription reminders by email to employees.

Overcome the Barriers
Each employer must decide the best strategy for improving medication adherence in the workforce. Today there are numerous options that did not exist even five years ago.

Helping employees manage their prescriptions is a crucial step in helping them manage their medical conditions while maintaining productivity. The right approach is a win-win for employees and employers.