Statin adherence is associated with higher likelihood of controlled disease, fewer outpatient and inpatient visits, lower outpatient and inpatient costs, and lower total costs, compared with nonadherence in a Medicare sample (J Manag Care Spec Pharm. 2020;26[12]:1529-1537. doi:10.18553/jmcp.2020.26.12.1529).
Adherence to medication is becoming increasingly important as populations age and chronic disease becomes more prevalent.
“The Pharmacy Quality Alliance (PQA) statin medication adherence measure is used in Medicare star ratings to evaluate health plan performance,” wrote David R Axon, PhD, MPharm, MS, University of Arizona College of Pharmacy, Tucson, and colleagues.
“Yet, limited evidence exists that investigates the association between statin medication adherence, as specified in the PQA adherence quality measure, and disease-state control, health care utilization [HCRU], and costs,” they continued. This study aimed to determine this association.
A cohort of eligible beneficiaries for inclusion in the PQA statin adherence measure with low-density lipoprotein (LDL) laboratory values was used to assess the association between adherence and LDL control. HCRU and costs were compared between adherent and nonadherent groups.
Among the statin adherent population, the odds of disease-state control were 2 times higher compared with the nonadherent group. Adherers experienced 4.7% fewer outpatient (RR = 0.953; 95% CI = 0.940-0.965) and 27.5% fewer inpatient (RR = 0.725; 95% CI = 0.687-0.766) visits compared with nonadherers.
Additionally, adherers had 9.9% lower outpatient (CR = 0.901; 95% CI = 0.885-0.916) and 28.3% lower inpatient (CR = 0.717; 95% CI = 0.705-0.729) costs. Total costs were lower by 14.7% (CR = 0.853; 95% CI =0.838-0.868) but prescription costs were higher by 7% (CR = 1.070; 95% CI = 1.052-1.089). Total reduction of costs per member per month for adherers was $157.32.
“This retrospective database analysis demonstrated that statin adherence was associated with approximately twice the odds of having a controlled disease state compared with nonadherence in a large Medicare sample,” Dr Axon and colleagues concluded.
“These results provide important new information by demonstrating that adherence (≥ 80%) is associated with lower health care costs in a short (1-year) time frame,” they added.—Lisa Kuhns
