Medication nonadherence, when patients do not take prescribed medication at doses and times recommended by a healthcare provider and agreed to by the patient1, carries substantial economic ramifications that extend across the entire economy2. It has been found that medication nonadherence contributes to $500 billion in avoidable healthcare costs each year3, indicating that this issue is on its way to becoming a global epidemic.
The most glaring impact of medication nonadherence on the economy is the contribution to increased healthcare expenditures, as when individuals fail to adhere to prescribed medications, their health conditions may worsen, leading to more frequent hospitalizations, emergency room visits, and costly medical interventions4. These costs not only strain the patient’s finances but also burden healthcare systems, which can be easily avoided through compliance with healthcare regimes5. Avoidable healthcare costs due to medication nonadherence are estimated to cost the U.S. healthcare system around $100 billion annually6. Similarly, estimated costs for medically nonadherent patients in 2015 were high across a variety of conditions and disease states: Osteoporosis ($43,000), Diabetes Mellitus ($7,000), Mental Health ($19,000), Addiction ($35,000), Parkinson’s disease ($40,000)7. Moreover, administrative complexity arises when additional time and resources must be spent adjusting treatment and handling additional paperwork due to the complications associated with nonadherence8.
Many chronic conditions are aggravated by medication nonadherence4, which in turn, will lead to increased absenteeism and decreased productivity in the workforce9. As employees struggle with health issues, employers bear the brunt of reduced output, increased disability claims, and the costs associated with finding and training replacements10. A study into the effects of medication nonadherence on absenteeism in the workplace showed that medically adherent employees took up to 7 days less off work, in comparison to nonadherent employees8. Integrated health and productivity management strategies—promoting a healthy work-life balance and fostering a good workplace environment—could help employees stay adherent to medication, and therefore reduce the strain on employers.
The strain on healthcare resources is exacerbated by medication nonadherence, leading to increased demand for medical services, pharmaceuticals, and specialized interventions11; studies have found that nonadherence causes as many as 25% of hospitalizations each year12. As a consequence, healthcare providers must allocate more resources to manage preventable complications arising from nonadherence, diverting funds and attention from other critical areas of healthcare. Investments in public health campaigns aimed at raising awareness about the importance of medication adherence may be the key to decreasing unnecessary hospital visits for patients, and reducing this financial burden.
In conclusion, the economic impacts of medication nonadherence are profound and multifaceted. From escalating healthcare costs to productivity losses and strain on healthcare resources, medication nonadherence imposes a substantial burden on societies and economies. Addressing this issue requires collaborative efforts from healthcare providers, policymakers, and individuals to implement effective strategies that promote medication adherence, ultimately leading to improved health outcomes and economic well-being.
References
Osterberg, Lars, and Terrence Blaschke. “Adherence to Medication.†New England Journal of Medicine, vol. 353, no. 5, 4 Aug. 2005, pp. 487–497, https://doi.org/10.1056/nejmra050100.
Stewart, Sarah-Jane F., et al. “Medication Nonadherence: Health Impact, Prevalence, Correlates and Interventions.†Psychology & Health, vol. 38, no. 6, 29 Nov. 2022, pp. 1–40, https://doi.org/10.1080/08870446.2022.2144923.
Watanabe, Jonathan H., et al. “Cost of Prescription Drug–Related Morbidity and Mortality.†Annals of Pharmacotherapy, vol. 52, no. 9, 26 Mar. 2018, pp. 829–837, https://doi.org/10.1177/1060028018765159.
Burnier, M. (2023). The role of adherence in patients with chronic diseases. European Journal of Internal Medicine. doi:https://doi.org/10.1016/j.ejim.2023.07.008.
McGuire, Maura, and Aurel Iuga. “Adherence and Health Care Costs.†Risk Management and Healthcare Policy, vol. 7, Feb. 2014, pp. 35–44, www.ncbi.nlm.nih.gov/pmc/articles/PMC3934668/, https://doi.org/10.2147/rmhp.s19801.
Cutler, Rachelle Louise, et al. “Economic Impact of Medication Non-Adherence by Disease Groups: A Systematic Review.†BMJ Open, vol. 8, no. 1, Jan. 2018, p. e016982, bmjopen.bmj.com/content/bmjopen/8/1/e016982.full.pdf, https://doi.org/10.1136/bmjopen-2017-016982. Accessed 16 Oct. 2019.
Berwick, D. M., & Hackbarth, A. D. (2012). Eliminating waste in US health care. JAMA, 307(14), 1513–1516. https://doi.org/10.1001/jama.2012.362
Carls, Ginger S., et al. “Impact of Medication Adherence on Absenteeism and Short-Term Disability for Five Chronic Diseases.†Journal of Occupational & Environmental Medicine, vol. 54, no. 7, July 2012, pp. 792–805, https://doi.org/10.1097/jom.0b013e31825463e9. Accessed 23 Oct. 2022.
Benjamin, Regina M. “Medication Adherence: Helping Patients Take Their Medicines as Directed.†Public Health Reports, vol. 127, no. 1, Jan. 2012, pp. 2–3, https://doi.org/10.1177/003335491212700102.
Lu, Z.K., Xiong, X., Brown, J., Horras, A., Yuan, J. and Li, M. (2021). Impact of Cost-Related Medication Nonadherence on Economic Burdens, Productivity Loss, and Functional Abilities: Management of Cancer Survivors in Medicare. Frontiers in Pharmacology, 12. doi:https://doi.org/10.3389/fphar.2021.706289.
National Institute for Health and Care Excellence (2009). Overview | Medicines adherence: involving patients in decisions about prescribed medicines and supporting adherence | Guidance | NICE. [online] Nice.org.uk. Available at: https://www.nice.org.uk/Guidance/CG76.
McDonnell, Patrick J., and Michael R. Jacobs. “Hospital Admissions Resulting from Preventable Adverse Drug Reactions.†The Annals of Pharmacotherapy, vol. 36, no. 9, 1 Sept. 2002, pp. 1331–1336, pubmed.ncbi.nlm.nih.gov/12196047/, https://doi.org/10.1345/aph.1A333.