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Study: Many don’t take drugs because of cost March 31, 2011

Posted by medvision in Cancer Care, Chronic Disease, Employee Wellness, health data, Healthcare Costs, Healthcare Reform, Insurance Plans, Risk Management, Rx Costs, Uncategorized.
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Some have heard my negative thoughts concerning High Deductible Health Plans (HDHPs) as a strategy to control health cost and quality. I won’t go into a diatribe, but I argue  relate to lower cost and high quality in the manner “dynamite” relates to sturdy hillsides.  Here’s another study looking at “cost” as a member barrier to preventative/lower cost care management. http://tinyurl.com/4gjjfc7

A relevant risk management question: If a member with advanced type 2 diabetes cannot afford plan-dictated prescription drug co-pays of $300 per month, and becomes non-compliant, is the plan sponsor at higher risk of a “shock” claim?  My thoughts are: The risk bearer/employer is “short-sighted” in trying to manage Rx and medical risk in separate silos.

Hmmm? $300 per month Vs. potential vascular events, renal failure, blindness, renal transplant and potential multiple amputations? I’ll take the $300/month, please!


Take your medicine! March 28, 2011

Posted by medvision in Cancer Care, Chronic Disease, Employee Wellness, health data, Healthcare Costs, Insurance Plans, Risk Management, Rx Costs, Uncategorized.
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Some elements responsible for our national out-of-control healthcare inflation are amazingly simple. Maybe plan managers, government policy makers and clinicians should stop–and take a few deep breaths: 50% of Americans fail to follow their doctor’s instructions concerning prescription drugs”  The short form is: We aren’t taking our medicine. This fact lines up with a dated Rand study finding 50% of Americans fail to receive recommended care. http://tinyurl.com/4ev7dbc

Does this have a large impact on our healthcare inflation? As a splinter of evidence the attached WSJ article indicates up to 90,000 Americans die annually from the failure to take blood-pressure medication. Med-Vision’s experience shows (3) factors responsible for poor Rx adherence:

(1) COST–Today large health plan managers have virtually “unlimited liability” associated with the total cost of adverse health events. Where’s the logic in assigning co-payment/co-insurance cost responsibility to the members, in today’s economy, who cannot afford and thus guaranteeing the (low-cost compared to hospital stay) medicine necessary to prevent a catastrophic medical event are not taken? Imagine if physicians medication orders were ignored by nurses in the inpatient acute care hospital setting? The next time a consultant offers advice to increase drug co-pays across-the-board, as a cost control strategy, maybe it’s time to suggest for him/her look for a new client.

(2) Untreated/under-treated DEPRESSION: Depression is classified as a mental illness and carries a significant social stigma. Many doctors will prescribe antidepressants, and due to concern of the patient’s medical records, fail to record a depression diagnosis. Today’s ramped up levels of anxiety coupled with the absence of free time and worries about the economy are pushing depressive symptoms to higher levels. Why not change the name “depression” to emotional wellness, make it known to the workplace the prevalence of this disabling condition and relay it’s ok to seek help. Depression is one of the most “curable” conditions. Why do people suffering from depression fail to take medicine? Feelings of lack of self worth, even suicide, are benchmark symptoms.

(3) Lack of education: Plan managers cannot simply provide plan members with a carrier web address and expect them to study the importance of taking their prescribed medications. Rx therapy compliance must be a central point with respect to wellness programs and other population based health education. Here’s an example of workforce perceptions concerning blood pressure medications. Today physicians have a large group of antihypertensive drug classes to help patients control blood pressure. One type, Beta Blockers, are sometimes contraindicated for men concerning sexual performance. Absent any clinical education, imagine the impact of one police officer’s story concerning “this” performance could have on 100s of male police officer’s adherence Rx therapy for any blood pressure class? Locker room discussions are the “grape-vine” of many employer organizations. The “grape-vine” should not be the information super-highway of critical health information to your employees!

Plan manager’s–part of  “taking your medicine” is to determine critical Rx compliance ratios for your own plans. The data are available. Don’t let anyone keep it from you!

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