Ask About Adherence: CMS finds medication adherence saved Medicare up to $46.6B in avoided health care costs between 2013 and 2018

Carolyn Ha
Carolyn Ha October 19, 2021

Ask About Adherence: CMS finds medication adherence saved Medicare up to $46.6B in avoided health care costs between 2013 and 2018.

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A recent Centers for Medicare & Medicaid Services (CMS) study found that medication use is improving among seniors and vulnerable beneficiary populations. Better adherence to medicines used to treat common chronic conditions such as high cholesterol, high blood pressure and diabetes is estimated to have saved the Medicare program between $27B and $46.6B in avoided health care costs between 2013 and 2018.

Specifically, improvements in medication adherence among Medicare Advantage and Part D beneficiaries during this period resulted in the following savings to the Medicare program in avoided health care costs:

  • Better adherence to statins saved $5.4B – $13.7B
  • Better adherence to diabetes medications saved $3.4B – $7.2B
  • Better adherence to anti-hypertensives saved $18.2B – $25.7B

Disparities in medication adherence also narrowed for Black, Hispanic and low-income Medicare Advantage beneficiaries. These encouraging results show that better use of medicines can lower health care costs and help reduce gaps in health inequities. But more needs to be done to make sure all patients are able to take their medicines as prescribed.

We support advancing policies and research to ensure patients can be adherent to medicines they need by improving:

  • Affordability by reducing insurance barriers and lowering patient out-of-pocket costs
  • Access by addressing barriers to screenings, diagnoses and treatment; and
  • Data to measure health disparities that could be used to improve quality measures.

Evidence-based measures of quality that are informed by clinical outcomes and patient feedback can also help ensure that patients have access to treatments that best meet their health needs and care goals that matter most to them. Quality and performance measurement should be supported by evidence and designed with the goal of ensuring that health care providers and other stakeholders can deliver high-quality patient care. This means care that is effective, safe, efficient, patient centered, equitable and timely.

Health care stakeholders (payers, providers, pharmaceutical manufacturers and quality measure organizations) should continue to collaborate with patients to develop clinically relevant quality measures that can help improve medication use.

America's biopharmaceutical research industry is ready to do its part to help ensure all patients can afford and access the medicines they need. To learn more, visit PhRMA.org/BetterWay.

Topics: Drug Cost, Medicare, Ask About Adherence