Link between hypertension drug adherence and total costs of care

Although adherence to hypertension medications was significantly associated with lower hospitalization rates, the total costs of care are higher for adherent patients than for patients who were deemed "non-adherent," according to a new study from pharmacy benefit manager Prime Therapeutics (Prime) that will be presented this week at the Academy of Managed Care Pharmacy (AMCP)'s 24th Annual Meeting & Expo in San Francisco.

The study found patients who were adherent to their hypertension medication had significantly associated lower hospitalization rates, although the higher drug expenses offset the lower medical costs resulting in a higher total cost of care. This result, according to the authors, differs from previous research showing lower hospitalization rates led to lower total costs, and may be due to population differences, including younger age.

Prime set out to compare one year of all-cause hospitalization rates, medical costs and pharmacy costs among patients who were adherent and non-adherent to hypertension medications. Working with the University of Minnesota College of Pharmacy, Data Intelligence Inc. of Eden Prairie, Minn., and one of its Blue Plan partners, Prime used retrospective data and medical claims from a commercially insured population of 3.6 million members with eligibility between 2007 and 2009.

Of the 91,931 members that fit the inclusion criteria of hypertensive patient, 66.4 percent (61,040) were adherent and 33.6 percent (30,891) were not. The adherent group was associated with a lower hospitalization rate (10.1 percent adherent vs. 11.1 percent non-adherent), lower medical costs ($7,124 adherent versus $7,441 non-adherent), higher pharmacy costs ($3,079 adherent versus $1,733 non-adherent) and high total cost of care ($10,203 adherent versus $9,174 non-adherent).

"Hypertension medication is associated with 20 percent lower hospitalization rate and lower medical costs," said Patrick Gleason, PharmD, director of clinical outcomes assessment at Prime. "Further research is needed, however, to assess the relationship between adherence and total costs of care."