Four out of ten Americans, about 129 million people, are suffering from a chronic health condition. Of those, 42% have two or more conditions and 12% are managing at least five. Chronic conditions are a serious health challenge, but they are also a financial one.

A recent observational study published in Thorax  found that Cost-Related Nonadherence (CRN), defined as not being able to afford needed medication, is alarmingly prevalent for people with chronic conditions. The study revealed that 1 in 6 adults with asthma who reported skipping, delaying, or reducing their medication doses to save money also experienced increased asthma attacks, more emergency room visits, worsening health, and ultimately, poorer quality of life.

The cost of prescription medications is a significant barrier for many Americans, but the 40% struggling with a chronic condition experience a twofold blow. The people who need access to medication the most face the highest cost barriers. The healthcare system can do better. Companies like RazorMetrics are using emerging technologies to innovate new solutions that address the pharmacy affordability issue for people with chronic conditions.

The Cost-Related Nonadherence Picture

A meta-analysis of studies showed the following numbers, and they paint a bleak picture:

• Thorax CRN Study on Asthma
  • Almost 18% of adults with asthma reported CRN.
  • 17% reported delaying refills, taking less medication, and skipping doses entirely.
  • CRN patients nearly doubled their risk for asthma attacks, and significantly increased risk for asthma-related emergency room visits.
• Vanderbilt University study on Nonadherence Among Adults Aged 65 Years and Older
  • 32.6% of CRN respondents reported fair or poor health (versus 18.0% of compliant respondents).
  • 41.4% of CRN respondents were extreme polypharmacy-taking 6 or more medications per month (versus 27.2% of compliant respondents)
  • 30.8% of CRN respondents had 6 or more chronic conditions (versus 13.3% of compliant respondents).
• CDC Study Cost-Related Nonadherence and Mortality in Patients With Chronic Disease
  • CRN was associated with 15% to 22% higher all-cause mortality rates for chronic conditions, being higher among people with diabetes, cardiovascular disease, and hypertension.
  • The prevalence of CRN in the U.S. is high, particularly among patients with chronic conditions.
  • 6% to 7% of U.S. adults reported at least 1 form of CRN.
  • 25% of adults with type 1 or type 2 diabetes reported rationing insulin in the previous year to manage costs, 3.2% reported rationing insulin on a daily basis.
  • 40% of adults with diabetes reported not discussing underuse or CRN with their physician.

Why Unaffordable Healthcare Persists

For the average person, managing one medical issue can stretch the budget, but when new conditions layer on, the costs quickly add up. Monthly maintenance drug costs can soar into the thousands of dollars, quickly eating up the average American paycheck. The cost of drugs remains a persistent hurdle for patients. Contributing factors include:

• High out-of-pocket costs, deductibles, and copays
• Limited coverage for certain chronic conditions
• Lack of access to drug cost solutions

How RazorMetrics Can Help

RazorMetrics is at the cutting edge of pharmacy cost containment.  By leveraging technology and data-driven insights, RazorMetrics helps employers and healthcare organizations reduce pharmacy costs while improving patient outcomes. Here’s how:

• Identifying Cost-Saving Opportunities: RazorMetrics offers an effortless pharmacy cost containment solution that never stops working in the background. Our proprietary RazorCodex™ automatically initiates cost-saving opportunities through medication switching, deprescription, deduplication, and more–all while adapting to fit your plan, preferences, and formulary.
• Reducing Member Out-of-Pocket Costs: By highlighting cost-effective options and providing actionable recommendations to physicians, RazorMetrics helps patients adhere to their prescribed treatments without breaking the bank.
• Enhancing Prescriber Education: Many prescribers are unaware of savings programs, biosimilars, or more affordable alternatives. RazorMetrics bridges this gap by delivering clear, concise, and personalized information to providers.
• Leveraging Technology: Our technology learns from every interaction, automatically updating based on drug cost, availability, and policy changes. We provide multichannel delivery options for physician approval; even when you don’t have updated prescriber information, our data enhancement service fills in the blanks.

Medication non-adherence due to cost hurts patients, but it also drains healthcare budgets from unexpected emergency services and poorer health outcomes. By prioritizing affordability and accessibility, payers and employers can reduce the risk of CRN among members with chronic conditions.

RazorMetrics is proud to be part of the solution. Our innovative approach works to help members, so they don’t have to choose between health and finances. Together, we can make medications affordable, improve adherence, and protect the high quality of life for your members.

Learn More: To discover how RazorMetrics can help your organization tackle high drug costs, visit us here.