ORLANDO, Fla. — AllianceRx Walgreens Prime and Walgreens recently announced results from separate research studies exploring the impact of adherence on hospitalizations and medical costs as they related to cystic fibrosis (CF) and ulcerative colitis (UC)/Crohn’s disease, respectively. Researchers wanted to better understand the effect of adherence on patient outcomes and well-being. Findings from both studies supported the idea that specialty pharmacy interventions focused on adherence may improve patient outcomes.
Access to commercial data prompted the research, according to Edward Witt, manager, health analytics, research and reporting at Walgreens, and an author of the study. “We wanted to understand the effect of adherence on total cost of care and other outcomes that we don’t usually have access to with pharmacy-only data.”
Both studies were retrospective analyses of a de-identified commercial claims database consisting of a national sample of patients.
CF is a progressive, genetic disease that causes persistent lung infections and limits the ability to breathe over time. CF transmembrane conductance regulator modulator (CFTRm) medications address the underlying cause of the disease. UC and Crohn’s disease are two types of inflammatory bowel disease (IBD), chronic conditions causing inflammation of the gastrointestinal tract. Biologic medications are often prescribed to help manage these conditions.
In both studies, researchers used pharmacy and medical claims data to determine patients’ adherence to their medication therapies and compare it to outcomes. Adherence was measured by using a proportion of days covered (PDC) metric among patients who had medical claims with ICD-10 codes for their respective study during 2019. Researchers examined outcomes including hospitalizations, inpatient bed days and inpatient costs.
Witt says the CF study found patients prescribed CFTRm therapies who were adherent to their medication were significantly less likely to be hospitalized during the same period as non-adherent patients. Among hospitalized patients, “the data showed a pattern such that inpatient costs were lower, and days stayed in the hospital were shorter for adherent patients relative to non-adherent patients. However, these differences were not statistically significant,” he says. “This study suggests the importance of adherence to these therapies for preventing worse health outcomes for patients.”
Witt went on to say the UC/Crohn’s study found UC and Crohn’s patients who were adherent to their biologics had fewer hospitalizations, shorter stays in the hospital if hospitalized and lower inpatient costs than non-adherent patients during the same time period. “The inpatient cost differences themselves were substantial,” he says. “This study suggests the importance of adherence in this patient population for reducing risk of negative health outcomes and financial costs and suggests the importance of establishing evidence-based specialty pharmacy adherence programs to improve adherence for UC and Crohn’s patients.”
Nishita Hira, PharmD, CSP, clinical program manager at AllianceRx Walgreens Prime and an author of the CF study, says the research findings reinforce the role specialty pharmacies play in supporting CF patients. “Specialty pharmacies can help support adherence through monthly touchpoints with patients. These include refill reminders and screening for and counseling on adherence barriers – such as administration difficulties or side effects – that may pose a threat to continued adherence,” she says. “Through improving adherence, specialty pharmacies can have a beneficial outcome on patient quality of life.”
The same holds true for patients with UC/Crohn’s disease, according to Renee Baiano, PharmD, CSP, clinical program manager at AllianceRx Walgreens Prime and an author of the UC/Crohn’s disease study. “The continual interaction between the patient, specialty pharmacy and provider is fundamental in the continuity of care for IBD patients. Specialty pharmacists can improve the quality of life for these patients by providing expert advice and support of treatment regimens, as well as by encouraging medication adherence.”
Witt says patients, payers and providers can learn from this study. “For patients, the message is staying adherent can keep you out of the hospital. For payers and providers, medication adherence is a key factor for reducing inpatient costs and improving quality of care.”
Researchers presented findings from both studies at ISPOR 2022, May 15-18, in Washington, D.C.