If you're one of the millions of Americans diagnosed with diabetes, large pharmacy benefits manager (PBM) Express Scripts (NASDAQ:ESRX) has good news for you. There's something you can do that will make you healthier. It could even make you wealthier, too.
Sound too good to be true? It's not. In fact, following this one simple step can do wonders for your health and your pocketbook. What is this amazing thing? Take your diabetes meds as prescribed. Here's what Express Scripts' research revealed about the benefits of simply taking your prescription drugs when you should.
If you have diabetes, you're at increased risk for several other conditions and complications. These other complications and conditions can include high blood pressure, high cholesterol, blindness, diabetic foot pain, nerve pain, and chronic kidney disease.
Diabetes and other related issues can make you more likely to go to the emergency room and be admitted to a hospital. Express Scripts found that diabetes patients are three times more likely to be admitted to a hospital and 1.6 times more likely to visit an ER.
There have been previous studies that showed non-adherence to diabetes medications increased the number of inpatient admissions and ER visits. Express Scripts' study reinforced this prior research. On average, diabetes patients who didn't take their medications had 1.5 times higher ER visit costs than those who were adherent to their prescriptions. Inpatient costs were 1.6 times higher for non-adherent diabetes patients.
Nearly 85% of diabetic patients are prescribed oral medications, with almost seven in 10 diabetic patients taking only these oral drugs. Most people (close to four in five) are prescribed metformin. A smaller percentage of patients take newer diabetes drugs such as Merck's (NYSE:MRK) Januvia and Johnson & Johnson's (NYSE:JNJ) Invokana. The problem is that too many patients are prescribed these drugs but don't take them like they should.
Express Scripts reported that only 63% of all commercially insured adults 20 years or older who were prescribed oral diabetes medications were adherent to their drug regimen. Yep, nearly four out of 10 diabetes patients didn't take their meds, even though taking the drugs should keep them healthier and out of the hospital.
Two groups of diabetes patients were particularly less likely to take their meds as they should: younger adults and women. Express Scripts found that less than half of individuals between the ages of 20 and 44 remained adherent to their prescriptions. Around two-thirds of diabetes patients ages 45 to 64 and nearly three-quarters of those aged 65 and over were adherent. For all age groups, women were less likely than men to take their diabetes meds as prescribed.
Since diabetes medications are intended to control the effects of the disease, it only makes sense that taking them as directed should keep patients healthier. But what about wealthier?
It's true that many diabetes drugs are costly, both to payers and to patients. Valeant Pharmaceuticals' (NYSE:BHC) metformin product Glumetza can cost upwards of $5,000 for 100 tablets at the 500 mg dosage. Merck's Januvia can cost around $1,200 for 90 pills at the 100 mg dosage. J&J's Invokana can run more than $350 per month.
However, if you have prescription drug coverage, whether through a private insurer or Medicare Part D or Medicaid, you won't have to pick up the tab all on your own. Also, much cheaper generic versions of metformin are available. Express Scripts even booted Valeant's Glumetza from its formulary in 2016 because of the high price tag in favor of generic alternatives.
The important thing to know, though, is that taking your diabetes drugs can be less expensive overall than not taking them. Express Scripts found that non-adherent diabetes patients paid nearly $493 on average per person last year in out-of-pocket costs than those who took their meds as prescribed. Why? The costs to patients for those ER visits and in-patient hospital stays add up.
Of course, Express Scripts, Merck, Johnson & Johnson, and other payers and diabetes drugmakers stand to become wealthier as well if adherence increases. Express Scripts gets paid more for increased prescription volume, while the big pharmaceutical companies would boost their product revenue.
Tips to stay on course
There were a couple of findings in the Express Scripts study that point to ways diabetes patients can be more adherent to their medication regimens. One is to get 90-day supplies of diabetes drugs. A much higher proportion of patients receiving 90-day supplies remained adherent than did those with 30-day supplies.
The other group of patients that claimed higher adherence rates were those that used home-delivery pharmacy services. This makes sense: If you don't have to go out of your way to get your meds, you're probably more likely to take them.
If you're currently on diabetes meds and are receiving 30-day supplies and/or going to a retail pharmacy to fill your prescriptions, changing to 90-day supplies and a home-delivery pharmacy could help you stay on course with taking your meds. There's one other thing you can do as well: Remember how taking those prescription drugs can make you healthier and wealthier. That should be pretty good motivation.