Thursday, January 20, 2011

More Evidence of Remote Monitoring Cost Savings

The results of new research, published in the January 2011 issue of Health Affairs (1), provide some interesting results that reinforce the importance of one aspect of remote monitoring: medication adherence. Compared to other studies, this one uses a more robust methodology, a larger sample size, demonstrates a strong link between adherence and reduced costs and directly refers to the benefits of remote monitoring. The study used data from 135,000 individuals with one or more of four chronic conditions, congestive heart failure, hypertension, diabetes and dyslipidemia. The article's conclusions provide an interesting perspective:

…“Our results indicate that despite higher pharmacy spending, medication adherence by patients with chronic vascular disease provides substantial medical savings, as a result of reductions in hospitalization and emergency department use. Benefit-cost ratios range from 2:1 for adults under age sixty-five with dyslipidemia to more than 13:1 for older patients with hypertension.

Given these findings, plan sponsors, government payers, and patients should consider participating in programs that improve medication adherence, as long as intervention costs do not exceed the estimated health care savings. Value-based insurance design, electronic monitoring devices, and pharmacist-led counseling are among the least costly alternatives. No matter what the intervention, actively encouraging medication adherence for chronic disease should be a top priority.”

The authors also stated that that the cost of an adherence intervention is directly related to the mode of delivery. Other studies that have assessed an intervention strategy involving heavy direct intervention by health professionals have not indicated results as strong as the ones reported here. The authors agreed with the results of an earlier study (2) that concluded: “Alternatives that require fewer resources—such as electronic monitoring devices and pharmacist-led patient counseling—have shown promise in improving patients’ medication adherence at less expense.”

(1)Roebuck MC, Liberman JN, Gemmill-Toyama M, Brennan TA. Medication adherence leads to lowerhealth care use and costs despite increased drug spending. Health Aff (Millwood). 2011;30(1
(2)Cutrona SL, Choudhry NK, Fischer MA, Servi A, Liberman JN, Brennan TA, et al. Modes of delivery for interventions to improve cardiovascular medication adherence: a systematic review. Am J Manag Care. 2010;16(12):929–42.

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