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Are You Adhering to Your Prescription Drug Regimen?

March 28, 2013 By: Nadia Category: HealthCare, Medicine Advice, Medtipster, Prescription News, Prescription Savings

Adhering to medication means taking the medication correctly, as instructed by a health care professional. This includes filling and refilling the prescription, taking it regularly, and continuing to take it for as long as prescribed. While this may seem simple, the World Health Organization has reported an average medication adherence rate of only 50 percent for people with chronic illnesses in developed countries. So, why is only half of the population taking their medicines as prescribed? Moreover, why is it important to adhere to your medication regimen anyway? Read on to find out why it’s important and how you can improve your adherence.

Why Adherence Matters?

Simply put, it can improve your overall quality of life. Evidence suggests that for many chronic illnesses, higher medication adherence reduces hospital visits. Fewer visits to the hospital mean lower medical costs as well.

Adherence to medication may be ‘easier said than done’ for many people. There are a variety of barriers that may make it difficult for patients to follow their medication therapy. Here are a few of those barriers and suggestions for how to get around them.

Cost

Often times, patients just cannot afford their medications. Perhaps there are alternative drugs available that do not cost as much. Talk with your prescriber or pharmacist. They may be able to help you find a more affordable drug.

You can also visit the Medtipster website, www.medtipster.com, to determine the cost of a prescription. The tool can help you compare the price on related drug products.

Side Effects

Your medicine may trigger unpleasant side effects, causing you to stop taking it. Talk to your doctor about these side effects. They may be able to switch you to a different medicine to reduce the side effects. They may also have suggestions for minimizing the side effects. Your doctor has your best interest in mind and is a knowledgeable resource to help improve your quality of life.

Feeling Better

There are five pills left, but you started to feel better and decided to stop taking your medicine. Before you stop, talk to your prescriber. Stopping early may cause more health problems. For instance, if a patient has a bacterial infection and stops taking his or her medicine early, some bacteria may still be alive. These bacteria could start a whole new strain of resistant germs. (U.S. Food and Drug Administration, 2009). Even though you may feel better, try to continue to take your medicine(s).

Forgetfulness

Make taking your medicine a part of your daily routine. Once you are used to taking your medicines regularly, it will not seem like a burden on your lifestyle. Buying a pill minder dispenser may help; it’s an easy daily reminder to take your medicine. Write down a schedule of when to take your medicines or add it to the calendar on your electronic device.

Health Care Beliefs and Attitudes

Some patients hold certain beliefs or attitudes that stop them from being adherent to their medication regimen. For example, a patient may believe that taking a medication as prescribed will not lead to a predicted outcome or that a particular disease state is not significant or will not lead to severe untoward outcomes. Talk with your prescriber about your beliefs. He or she may have more information about your illness and medicine than you know.  Your prescriber can tell you why it is in your best interest to adhere to taking your medicine(s).

Adhering to your medicine can improve your overall quality of life, so take care to adhere to your prescribed medication regimen. For a better result, you will be glad you attended to your health.

Employers Grapple With Birth Control Mandate

May 09, 2012 By: Nadia Category: HealthCare, Medicine Advice, Medtipster, Prescription News

www.Medtipster.com Source: Employee Benefit News, 5/1/12 – By, Lisa V. Gillespie

Federal contraception coverage mandate raises ire among insurers, may raise premiums for health plan members

The intersection between religion and business is a heated one, with the most recent flare-up sparked by a provision in the Patient Protection and Affordable Care Act that mandates employers cover the cost of contraception in their health plans. Although the Obama administration exempted houses of worship from the rule, it still requires coverage be made available to employees of religiously affiliated organizations such as hospitals and universities.

The administration has said insurers should ultimately make up any initial costs by avoiding expenses associated with unintended pregnancies. But a survey of 15 large health plans shows they are dubious of such savings.

Asked what impact the requirement will have on their costs in the year to two years after it goes into effect, 40% of insurers said they expect the requirement will increase costs through higher pharmacy expenses.

The survey of pharmacy directors at the health plans was conducted by Reimbursement Intelligence, which advises pharmaceutical, medical device and other companies on reimbursement issues. The firm did not name the insurance plans it surveyed.

Of the health plans, 20% said costs would even out because they already budget for contraception in the premium, 6.7% said it would drive up pharmacy costs but decrease medical costs, while 33.3% weren’t sure. None said it would lead to net savings.

“[Insurers] think it will raise pharmacy costs and won’t lower medical costs,” says Rhonda Greenapple, chief executive officer of Reimbursement Intelligence. “The idea that preventive care is going to reduce overall health care costs, they don’t buy it.”

In addition to health insurance companies, lawmakers also have questioned the precedent set by Obama’s plan that would force insurers to pay for coverage with no clear way of recouping the expense. “The idea that insurance companies are going to provide free coverage for items contained in the administration’s order reflects a misunderstanding of the business of insurance,” says Rep. Dan Lungren (R-Calif.). “Under its ‘accommodation,’ the religious employer continues to pay premiums that contribute to the revenues of the insurers. The money paid by religious employers for what will inevitably be higher premiums thereby frees up insurer funds to pay for abortion-inducing drugs, sterilization and contraception in violation of their strongly held beliefs.”

The guidelines require insurers to do away with copayments on coverage of preventive care services for women in all new plans beginning in August. A poll from the Kaiser Family Foundation in February showed nearly two-thirds of Americans favor the policy requiring birth control coverage for female employees, including clear majorities of Roman Catholic, Protestant evangelical and independent voters. Sixty-three percent of Americans overall supported it, according to the data.

But Catholic leaders, Protestant evangelical groups, Republicans and other social conservatives rejected the compromise, saying it still violates religious freedom under the U.S. Constitution and would cause economic hardship for self-insured institutions. The controversy has spawned a rancorous debate in Congress as well as a handful of Catholic lawsuits, including a federal suit in Nebraska joined by seven U.S. states.

Employer response

Some employers have voiced support for the rule, including one reader of EBN’s blog Employee Benefit Views, who said his/her employee population consists mainly of lower-income employees “who make $10 to $15 an hour who may not use birth control – not because of religious reasons, but because they cannot afford the cost of the birth control and keep a roof over their heads. I work for a self-funded employer, and this would create additional costs for us. However, these could possibly be off-set with the savings from births, disability leaves and the like.”

That cost savings may be attractive to employers constantly looking to reduce health care cost burdens. “I understand the issue of ‘religious freedom’ here, but just because this coverage is offered by your insurance company, does not mean that you have to use it,” wrote another EBV commenter. “I would think that each adult can make their own choice on whether or not this is a benefit [they] want to use. But the coverage is there, then, for those individuals who want and need that coverage. Better than the alternative of unwanted pregnancies, abortions and the like.”

Other readers likened the coverage of contraception to coverage to treat chronic conditions. “I do understand the perspective of the employer not wanting to pay for a benefit they do not condone,” a third EBV commenter wrote. “I don’t condone many of the activities that lead to diabetes or heart disease. But I still have to pay for the people that have those habits.”

Employer healthcare costs expected to rise 9% in 2011, according to PricewaterhouseCoopers

June 15, 2010 By: Nadia Category: HealthCare, Medtipster, Prescription News

www.Medtipster.com Source: www.pwc.com – June 14, 2010

The nation’s employers can expect medical costs to increase by 9% in 2011, a decrease of 0.5% from the 2010 growth rate, according to the annual Behind the Numbers report published today by the PricewaterhouseCoopers LLP (PwC) Health Research Institute. For the first time, the majority of the American workforce is expected to have a health insurance deductible of $400 or more, as more employers return to “indemnity style” cost-sharing by raising out-of-pocket limits, replacing co-pays with co-insurance and adding high-deductible health plans.

The Behind the Numbers report includes findings of the PricewaterhouseCoopers’ Health and Well-Being Touchstone Survey of more than 700 employers from 30 industries, as well as interviews with health plan actuaries and other executives whose companies provide health insurance for 47 million American workers and their families.

Improving wellness programs and increased cost-sharing lead the planned changes employers will make in the benefit plan designs they will offer for next year. According to PricewaterhouseCoopers’ Touchstone research:

  • Two-thirds (67%) of companies intend to expand or improve wellness programs inside the US
  • 42% intend to increase employee contributions for health insurance coverage.
  • 41% intend to increase medical cost-sharing, including higher deductibles and co-pays, while only 26% intend to increase prescription drug cost-sharing.
  • More employers are dropping health benefits for retirees. One-third of employers with over 5,000 workers subsidize pre-65 retiree medical coverage, down from 47% in 2009. Only 22% of employers with over 5,000 employees subsidize post-65 retiree medical coverage, down from 37% in 2009.

In 2011, the Behind the Numbers report outlines three primary deflators that will help employers hold down medical costs:

  • Employers are moving toward pre-managed care benefit design by increasing deductibles and replacing co-pays with co-insurance. By requiring workers to spend more out-of-pocket at the point of care, employers believe they will rein in utilization of services and drugs. The number of employers using co-insurance for physician visits has nearly doubled, and one-third use co-insurance for brand-name drugs.
  • Drug costs are tempered by generics. Insurers are benefitting from the growing use of generic drugs. Drugs representing about $26 billion in annual sales are expected to go off patent in 2011, including the world’s best-selling drug, Lipitor. Generics account for as much as 80% of all prescriptions.
  • COBRA costs are expected to return to more normal levels in 2011. COBRA subsidies passed by Congress in 2009 created a 1% increase in the medical cost trend, according to PricewaterhouseCoopers’ analysis. A combination of declining unemployment and expiration of the COBRA subsidies is expected to lead to reduced enrollment in COBRA.

The biggest inflators of the medical trend in 2011 will be in hospital and physician costs, which make up 81% of premium costs. 

  • Hospitals shifting costs from Medicare to private payers and employers is seen as the Number One reason for higher medical costs trends. In 2011, Medicare, which is the single largest payer for hospitals, will reduce payment rates to hospitals for the first time after seven years of increases that nearly matched or exceeded inflation increases. Some hospitals that benefitted from higher payments in 2008 and 2009 may be able to manage this type of cut by tapping their reserves. Yet, more are likely to shift more costs to commercial payers during their negotiations.
  • Provider consolidation is increasing, which is expected to increase their bargaining power. More physicians are getting out of private practice and joining forces with local hospitals or larger physician groups. The number of physicians involved in mergers or acquisitions in 2009 was 2,910, nearly twice that of 2008. There has been record consolidation activity in 2010, and PricewaterhouseCoopers expects the trend to accelerate in 2011. Payers expect to see more negotiating power and higher prices in the short term, though the benefits of consolidation should create efficiencies that moderate rate increases in the future.
  • Spurred by stimulus funding that begins in 2011 and Medicare penalties that begin in 2015, hospitals will invest billions of dollars in certified electronic health record (EHR) systems. While many hospital systems were planning to implement EHRs in the near future, the government’s new regulations dramatically condensed their timelines to invest in technology, IT staff, training and process redesign. Healthcare CIOs surveyed by PwC said they will make their largest investments to meet the new EHR regulations in 2011. In the long term, EHRs are expected to help control costs. 

“For more than 50 years, US employers have used health benefits as a critical part of their compensation package to recruit and retain workers,” said Michael Thompson, principal, Human Resource Services, PricewaterhouseCoopers. “The value of these benefits is becoming an even more visible part of overall compensation as medical costs grow, and, by 2014, health insurance benefits will shift from being a voluntary benefit to an individual mandate, enforced by new tax levies. Companies are now working with their health plan providers for new post-recession, post-health reform strategies to sustain their programs and promote health and well-being as their next competitive advantage.” 

Each year, PricewaterhouseCoopers’ Health Research Institute provides estimates on growth of private medical costs over the next year and what the leading drivers of the trend are expected to be. Insurance companies use medical cost trends to help set health plan premiums by estimating what the same health plan this year would cost in the next year. In turn, employers use the information to make adjustments in benefit plan design to help offset any cost increases. 

“Health reform delivers only a minor impact on the underlying medical cost trends in 2011 and introduces hundreds of changes in the healthcare system designed to reduce costs and improve efficiencies in the long-term,” said Kelly A. Barnes, US health industries leader at PricewaterhouseCoopers. “These changes could bring significant new cost savings opportunities for employers and payers as well as new choices and transparency for workers buying insurance.” 

PricewaterhouseCoopers’ Behind the Numbers report and survey highlights are available at www.pwc.com/us/medicalcosts2011. The full findings of the PricewaterhouseCoopers 2010 Health and Well-being Touchstone survey are available at  www.pwc.com/us/touchstone2010.For more on the details on the implications of health reform, go to http://www.pwc.com/healthreform

Methodology

The 2010 Health and Well-Being Touchstone survey was completed in the first quarter of 2010. Survey participants included 700 U.S- based companies across the country from 30 different industries. Companies ranged in size from small employers with fewer than 500 employees to large companies with more than 20,000 employees. 

About PricewaterhouseCoopers’ Health Research Institute (HRI)

PricewaterhouseCoopers’ Health Research Institute (www.pwc.com/hri) is an unparalleled resource for health industry expertise. By providing cutting-edge intelligence, perspective and analysis on issues impacting the health industry, HRI assists executive decision-makers and stakeholders worldwide in navigating their most pressing business challenges. PricewaterhouseCoopers is one of the only firms with a dedicated global healthcare research unit, capitalizing on fact-based research and collaborative exchange among our network of professionals with day-to-day experience in the health industries. 

About PricewaterhouseCoopers’ Health Industries Group

 PricewaterhouseCoopers’ Health Industries Group (www.pwc.com/healthindustries) is a leading advisor to public and private organizations across the health industry, including payers, providers, academic institutions, health sciences, biotech/medical devices, pharmaceutical companies, employers and new non-traditional market participants in the dynamic healthcare space. PricewaterhouseCoopers has a network of more than 4,000 professionals worldwide and 1,200 professionals in the US dedicated to the health industries.

PricewaterhouseCoopers’ Health Industries’ clients include 40 of the top 100 hospitals in the US and 16 of the 18 best hospitals as ranked by US News & World Report; all 20 of the world’s major pharmaceutical companies; all of the top 20 commercial payers in the US; municipal, state and federal government agencies and many of the world’s preeminent medical foundations and associations. Follow PwC Health Industries at http://twitter.com/PwCHealth.

About PricewaterhouseCoopers
PricewaterhouseCoopers (www.pwc.com) provides industry-focused assurance, tax and advisory services to build public trust and enhance value for its clients and their stakeholders. More than 163,000 people in 151 countries across our network share their thinking, experience and solutions to develop fresh perspectives and practical advice.

“PricewaterhouseCoopers” refers to PricewaterhouseCoopers LLP or, as the context requires, the PricewaterhouseCoopers global network or other member firms of the network, each of which is a separate and independent legal entity.

© 2010 PricewaterhouseCoopers LLP. All rights reserved

 Lisa Stearns
The Hubbell Group, Inc.
Tel: +1 (781) 878 8882
lstearns@hubbellgroup.com

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