Misuse of prescription drugs costs the US $200 billion annually, according to a press release by IMS Health regarding a recent study. Those unnecessary costs represent about 8% of the yearly national healthcare expenditure, and could have paid for the healthcare of 24 million uninsured patients, by the study’s calculations.
“As our study makes clear, drugs are often not used optimally, resulting in significant unnecessary health system spending and patient burdens,” reports Murray Aitken, executive director of the IMS Institute for Healthcare Informatics.
The report examined six areas that contribute to unnecessary costs: medication nonadherence, delayed evidence-based treatment practice, misuse of antibiotics, medication errors, suboptimal use of generics, and mismanaged polypharmacy in older adults. The investigation revealed that misuse of medical resources was a factor in 10 million hospital admissions, 78 million outpatient treatments, 246 million prescriptions and four million emergency room visits annually.
In particular, medication nonadherence was responsible for $105 billion in annual avoidable health-care costs, or more than half of the total figure, as patients who do not follow their clinician’s instructions regarding prescribed medication leads to greater subsequent expenses.
Patients are not the only culprits, however, as delays in diagnosis and treatment also account for $40 billion in annual expenses. These delays often lead to costly and otherwise unnecessary hospitalizations, especially for diabetes patients who are particularly vulnerable to such tardiness.
Yet the study was able to pinpoint areas of improvement while also suggesting methods to further ameliorate the issue of expensive misuse of drugs.
“Even though avoidable costs are significant, encouraging progress is being made in addressing some of the challenges that drive wasteful spending in many parts of the healthcare system,” the study noted.
For patients with hypertension, hyperlipidemia and diabetes, three common chronic diseases, medication adherence has improved since 2009 by about 3%. Moreover, the number of patients who unnecessarily received antibiotic prescriptions for a cold or the flu has dropped from 20% to 6% since 2007, an important development considering that $34 billion is wasted annually on misuse of antibiotics.
In general, patients are relying on lower-cost generic medications more often, as use of generics when available reached 95% in 2012 .
Still though, there are several significant opportunities for improvement. An even greater dependence on generics could save an extra $10 billion.
Additionally, expansion of insurance coverage and increases in the frequency of screening could help clinicians and patients avoid delays in treatment, whereas a larger role for pharmacists, a more integrated approach to addressing patient issues, and the establishment of financial incentives for clinicians might also contribute to a reduced health-care bill.
“Reaching a meaningful level of consensus and alignment among stakeholders, based on measured and proven success models, is a key step to unlocking the $200 billion opportunity identified in our study,” the study concluded.