The Cost of Improving Treatment Choices: Cost and Benefit of a Digital Medicine System that Collects and Reports Objective Medication Adherence
Background: Medication adherence is critical for relapse prevention among SMI patients. In the absence of objectively collected adherence data (OCAD), managing medications is difficult. A digital medicine system (aripiprazole tablets with sensor) (DMSA) that provides OCAD to providers was studied for its potential cost and clinical benefit.
Methods: Providers reviewed case vignettes of schizophrenia (SZ), bipolar disorder (BD) or major depressive disorder (MDD) patients and chose from an array of treatment choices. The vignettes included symptoms, thoughts, behaviors and self-reported medication adherence. Experimental condition vignettes included OCAD, like that produced by the DMSA. Differences between groups were attributed to presence of OCAD. The cost impact of the DMSA was estimated using budget impact modelling. Prevalence of SMI, market share and unit costs based on literature and data on file. The model assumes the DMSA will be used for 2 or 3 months to assess OCAD.
Results: Providers completed the SZ (n=219), BD (n=90) and MDD (n=90) surveys; 60.0% were female, 52.2% were ≤39 years of age, and 91.6% had a medical degree. Following non-adherent patient vignettes, SZ and BD experimental condition providers were more likely to switch patients to a LAI (SZ: 77.7% vs. 25.8%; BD: 69.6% vs. 22.7% p < .01). The estimated impact of the DMSA upon a 1,000,000-member pharmacy budget was ($0.11) months per member per month.
Conclusions: Though the DMSA has the potential to facilitate more informed treatment decisions, the cost of managed care pharmacy budget is relatively modest when used for 2 or 3 months.
This poster was presented at the 32nd annual Psych Congress, held Oct. 3-6, 2019, in San Diego, California.
