Stakeholders unite on cost analysis for medication adherence programs

From patient to payer, ISPOR commentary reveals critical insights on medication adherence programs.

The commentary “Stakeholders’ Perspectives on Medication Adherence Enhancing Interventions,” published in ISPOR’s Value in Health, is based on a 2023 review of systematic literature by the ISPOR Medication Adherence and Persistence Special Interest Group.

The commentary, based on the findings that evaluated measures used in assessing medication adherence enhancing interventions (MAEIs), came from the various stakeholders including patients, manufacturers, providers, health technology assessment agencies, and payers.

Perhaps to be expected are the differences among each stakeholder representative—KOLs in their fields—regarding what they want to see in an MAEI. However, the conclusion said that they agreed “that future studies should focus on quantifying the costs associated with MAEI implementation and how such costs are borne by different stakeholders.”

The following are some points garnered from each of the perspectives:

Patient: MAEIs should be tailored to the individual, for example some patients need more financial support, while others may need more social support and considerations, such as cognitive challenges or loss of work challenges that impact adherence.

Manufacturer: Focusing on how to optimize MAEI is a priority. Programs that support patients in adherence both financially, behaviorally, and educationally are supported. They are also looking at AI to target barriers. Manufacturers continue to rely on the real-world evidence that is supported by medication adherence for both regulatory and payer considerations.

Providers: With the gamut of providers including community pharmacies, community health workers, and HCPs, most rely on educational materials and training. Training consists of health equity and social determinants of health identification.

HTA: Because of the nature of nationally funded health systems, HTAs “evaluate improving patient outcomes, such as Health-Related Quality of Life (HRQoL) and survival, along with their cost-effectiveness for healthcare payers.” As such, HTAs have limited insights from strict MAEI studies as being too narrow, leaving the association between medication adherence and HRQoL lacking.

Payer: The payer looks more favorably upon MAEIs as a way to mitigate non-adherence and its contribution to increased healthcare costs. Because of the relationship of prescription drugs in the US, payers view the provider-to-patient support as key.