Ask About Adherence is a blog series featuring Q&A’s with experts and new medication adherence resources. In this post, we are pleased to share a blog post from Lauren Gilstrap, MD, MPH.
Conversations and healthy debate about issues facing our industry and the health care system are critical to addressing some of today’s challenges and opportunities. The Catalyst welcomes guest contributors, including patients, stakeholders, innovators and others, to share their perspectives and points of view. Views represented here may not be those of PhRMA, though they are no less key to a healthy dialogue on issues in health care today.
A recent study published in Diabetes Care finds that about one-third of patients with uncontrolled diabetes aren’t taking medication, and almost 20 percent are on inadequate treatment regimens. Proper treatment is not only essential for controlling glucose levels, but also in preventing other complications such as heart or kidney disease that can contribute to increased medical costs.
Researchers from Harvard University looked at extensive data from commercially insured patients spanning over seven years to identify specific patient factors and variation in treatment patterns. The study concluded that over 30 percent of patients had not started diabetes treatment within six months of an elevated blood glucose test and that 18 percent of patients did not have their treatment intensified within six months of an elevated blood glucose test. The rates of initiating and intensifying treatment both increased over time (by 20 percent and 10 percent, respectively).
For diabetes patients, appropriate use of medicines includes initiating and adhering to treatment as recommended by a physician. It may also include intensifying the treatment regimen if a patient shows a lack of response, by either an increase in dose, addition of a new medicine or switching to another type of medicine such as insulin. Delays in the initiation and intensification of therapy is estimated to contribute to at least 200,000 related adverse events per year.
Diabetes costs the U.S. health care system $245 billion annually, and diabetes patients spend an average of $16,752 per year on medical costs. A key aspect of effective diabetes management is appropriate use of medicines to prevent future health complications. Proper adherence to diabetes medicine is estimated to generate $8 billion in savings per year from avoided hospitalizations.
This study demonstrates that there is significant opportunity for improvement in care for diabetes patients. Better treatment patterns can decrease associated complications and mortality rates, and ultimately lower overall medical spending.
Lauren Gilstrap, MD, MPH is an Assistant Professor of Health Policy at The Dartmouth Institute and an advanced heart disease and cardiac transplantation attending at Dartmouth-Hitchcock Medical Center. She obtained her medical degree from Harvard Medical School and her Masters in Public Health from the Harvard T.H. Chan School of Public Health. Dr. Gilstrap’s current research focuses on quality measurement and improvement for chronic, cardiometabolic disease. She also evaluates the impact of alternative payment programs on patient outcomes and the diffusion of novel therapies and technologies across health systems.