If every patient complied with medical guidelines and took their prescribed medications (preferably generics, if available), America would save billions of dollars each year. This is revealed by the "2013 State of the States: Adherence Report" drawn up by CVS Caremark, which underlines the pharmacoeconomic value of compliance. The authors of the report estimated the potential savings achievable in each state in four clinical conditions (diabetes, arterial hypertension, dyslipidemia, depression) after analyzing treatment adherence rates as well as relative generic drug prescribing. According to the authors, "the overall savings potential ranges from $19 million to $2.1 billion, depending on state characteristics." The report also highlights that there would be a savings of $13.4 billion if doctors switched from brand-name medicines to less expensive generic drugs in the United States; also because, he points out Troyen Brennan, Chief Physician at CVS Caremark, most patients treated with the more expensive brands have never looked for generic alternatives. In particular, the state that could benefit from the greatest savings is Texas (1.4 billion dollars), followed by California (1.2 billion dollars). Regarding the problem of adherence to therapy, the report argues that much can be done in the face-to-face relationship of the patient in the pharmacy, when behavior can be influenced more than with "a sealed envelope or even a phone call". Further elements identified by the researchers as a reason for excessive pharmaceutical expenditure are the delay in setting up an Ebm therapy, medical errors, the inappropriate use of antibiotics and the improper use of multiple treatments. Finally, a large share of savings is identified in the switching of antiretroviral therapies to generic drugs in HIV-positive patients.
8 July 2013 – DoctorNews33
