Study shows younger adults with high cholesterol not adhering to prescribed medications

A study released today by CVS Caremark (NYSE: CVS) found that more than 50 percent of patients under the age of 45 who are prescribed a medication to treat high cholesterol are not optimally adherent to their therapy. In fact, the data showed that 58 percent of adults between the ages of 18-34 are not taking their cholesterol lowering medications as prescribed.

According to the National Institutes of Health's National Heart, Lung and Blood Institute (NHLBI), high cholesterol affects more than 65 million Americans. Because high cholesterol does not cause symptoms, individuals may not be aware that they are at increased risk of developing heart disease or experiencing a heart attack. September is National Cholesterol Education Month, and is a good opportunity for people to get their cholesterol levels checked and take steps to lower their levels if they are high.

"This data illustrates that younger adults with high cholesterol are not taking their medication as prescribed, putting them at increased risk for developing heart disease, worsening their long term clinical outcomes and ultimately increasing the cost of their care," said Troyen A. Brennan, M.D., M.P.H., Executive Vice President and Chief Medical Officer, CVS Caremark. "CVS Caremark engages plan participants with chronic diseases, such as high cholesterol, by addressing barriers to evidence-based care. We engage patients in their care early in the process by providing disease and therapy education and help them improve medication adherence through proactive intervention and outreach."

The study examined adherence to cholesterol lowering medications by evaluating de-identified data for more than 74,000 adult patients from the CVS Caremark Health Management Claims Database who incurred claims for a cholesterol lowering medication between January 1, 2008 and December 31, 2008. All study participants were continuously eligible for pharmacy benefits for the entire evaluation period. Results found that only 42 percent of patients between the ages of 18-34 were optimally adherent to their medications with a medication possession ratio (MPR) of greater than 80 percent. In addition, among those patients aged 35-44, only 50 percent were identified as optimally adherent to their high cholesterol medication.

The CVS Caremark Proactive Pharmacy Care approach engages patients earlier with education and personalized outreach to improve adherence. The Adherence to Care solution is a mail and retail based program designed to impact patient behavior through timely interventions that include face-to-face, first fill counseling; IVR and Web refill reminders, renewals and pick-up prompts; and personalized letters about the importance of staying on a prescribed therapy sent to those patients who have stopped filling a maintenance prescription and their health care provider. The Adherence to Care program has been shown to help increase adherence to high cholesterol therapies with those members under 45 years of age who participate in the program experiencing an MPR increase of more than 9 percent.

Medication possession ratio (MPR) is the standard statistic used to measure medication adherence via pharmacy claims. MPR assesses if a patient has a sufficient quantity of medication dispensed to suggest the medication is being taken as prescribed. MPR is represented as a ratio of total days supply of medication divided by the total days in the measurement period. In this study, MPR was calculated using the DMAA methodology on pharmacy claims incurred by the study subjects. Patients with an MPR greater than or equal to 80 percent were considered optimally adherent to therapy. This analysis is an observational study only, and the results demonstrate a correlation between patients under age 45 and suboptimal adherence to cholesterol lowering medications; however, as in most observational studies, the causal nature of this relationship cannot be determined.

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