Digital Technologies: The Solutions to Poor Medication Adherence?
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1 Digital Technologies: The Solutions to Poor Medication Adherence? Jeffrey Mesaros, PharmD Annual Meeting & Exposition Seattle, Washington March
2 Disclosures The views and opinions expressed in the following presentation are those of the individual presenter and should not be attributed any organization with which the presenter is employed or affiliated. This presentation is intended to provide an overview of our perspective of high-level trends and regulatory activity related to compounding pharmacies and not intended to provide legal advice. 2
3 CPE Information Target Audience: Pharmacists ACPE#: L03-P Activity Type: Knowledge-based 3
4 Learning Objectives At the completion of this knowledge-based activity, participants will be able to: 1. Describe how poor medication adherence impacts drug costs in the United States. 2. List available digital technology solutions in pharmacy. 3. Outline how digital technology can improve medication adherence. 4. Define regulatory considerations related to digital technology in healthcare. 4
5 Assessment Questions 1. Adherence A. is lowest among patients with acute illness B. is lowest among patients with chronic illness C. has little to no impact on medication related hospital admissions D. cannot be addressed my pharmacists 5
6 Assessment Questions 2. Which of the following are not digital technologies available in pharmacy: A. Smart Caps B. Telepharmacy C. Mobile Apps D. Mortar & Pestle 6
7 Assessment Questions 3. Digital technology can improve medication adherence through all of the following except: A. Increased access to pharmacy services B. Ingestible technology solutions C. Delivery solutions D. Restrictive regulatory environments 7
8 Assessment Questions 4. All of the following are regulatory considerations related to digital technology, except: A. DEA B. State Boards of Pharmacy C. North Carolina Dental Board D. FDA 8
9 Can digital technologies solve our $300 billion medication adherence problem? 9
10 Agenda 1. The challenge of medication adherence 2. Digital solutions to the non-adherence problem 10
11 Medication non-adherence a 300 billion dollar problem. $290 billion $100 billion Annually in mostly avoidable costs to treat adverse events from inappropriate medication use Medication non-adherence alone results in each year in excess hospitalizations. 11
12 Medication non-adherence a 300 billion dollar problem. In the United States the estimated direct and indirect cost of non-adherence is around $337 billion -> costs $2,000/patient in additional physician visits (6) Poor medication adherence is responsible for percent of all medication related hospital admissions, at a cost of about $100 billion per year (4) 125,000 Americans die annually due to poor adherence (3) Adherence is lowest among patients with chronic illness (5) 1. Accessed Accessed McCarthy R, The price you pay for the drug not taken. Bus Health. 1998;16:27-28,30, Osterberg L, Blaschke T, Adherence to Medication, New Engl. J. Med., 2005;353(5): Sokol MC, McGuigan KA, Verbrugge RR, Epstein RS. Impact of Medication Adherence on Hospitalization Risk and Healthcare Cost. Med Care. Jun 2005 ;43(6): The Costs of Nonadherence. Express Scripts White paper
13 Medication non-adherence a 300 billion dollar problem. ORAL ONCOLOGY - Adherence may be as low as 15% in patients taking oral oncolytics (3) BREAST CANCER - Estimated 10-year survival rate in one study for non-adherent patients was 77.9% vs. 81.7% for those who were (3) TRANSPLANT % of liver transplant patients are non-adherent to immunosuppressants (2) 1.A Tough Pill to Swallow. Medication Adherence and Cardiovascular Disease. American Heart Association Patrizia Burra et all., Adherence in Liver Transplantation Recipients. LIVER TRANSPLANTATION 17: , Lea Ann Hansen. Impact of Nonadherence to Cancer Therapy. Journal of Hematology oncology pharmacy. May
14 The Leaky Bucket Out of every 100 new prescriptions arrive at a pharmacy are picked up by the patient are taken properly are refilled as prescribed Source: IMS Health Data, March
15 Agenda 1. The challenge of medication adherence 2. Digital solutions to the non-adherence problem 15
16 types of adherence systems Reminder systems/apps/avatars Smart injectors/inhalers Therapeutic/Regulated APPs PACKAGING SOLUTIONS Smart pill bottles/caps In-home dispensers Pharmacist services DIGITAL PILLS 16
17 mobile smartphone based monitors Visually confirms medication ingestion. Uses phone to see when you re taking meds Uses facial recognition to ensure correct patient is ingesting medication. Due to this can detect duplicate patient enrollment and also fraud Can ID meds similar to how a bar code works 17
18 therapeutic/regulated apps 18
19 smart pill bottles in-home dispensers packaging solutions 19
20 smart injectors / inhalers 20
21 digital medications 21
22 ID cap 22
23 Provider/EMR Pharmacy Payer/PBM ID-Capsule Reader Mobile App Management System Pharmaceutical Manufacturer 23
24 pharmacist services 24
25 pharmacist services 25
26 pharmacist services 26
27 Assessment Questions 1. Adherence A. is lowest among patients with acute illness B. is lowest among patients with chronic illness C. has little to no impact on medication related hospital admissions D. cannot be addressed my pharmacists 27
28 Assessment Questions 2. Which of the following are not digital technologies available in pharmacy: A. Smart Caps B. Telepharmacy C. Mobile Apps D. Mortar & Pestle 28
29 Assessment Questions 3. Digital technology can improve medication adherence through all of the following except: A. Increased access to pharmacy services B. Ingestible technology solutions C. Delivery solutions D. Restrictive regulatory environments 29
30 Assessment Questions 4. All of the following are regulatory considerations related to digital technology, except: A. DEA B. State Boards of Pharmacy C. North Carolina Dental Board D. FDA 30
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