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Support of State and Federal Policies to Improve Medication Adherence


WHEREAS, medication non-adherence remains a key public health concern, although a number of stakeholders in the healthcare sector have invested significantly in efforts to address the problem.

WHEREAS, lack of adherence to prescribed medications results in higher medical costs and poorer outcomes for patients. Approximately 125,000 deaths per year in the U.S. are attributable to non-adherence, and 33% to 69% of hospital admissions related to medications are a result of non-adherence.

WHEREAS, the estimated direct and indirect costs of non-adherence totaled $337 billion in 2013.

WHEREAS, non- adherence factors are diverse and complex. The lack of health literacy, difficulties in obtaining reliable transportation, complexity of the patient’s condition and co-morbidities are all examples of the factors.

WHEREAS, engagement with patients, and their caregivers at the time of discharge from an acute care setting is imperative to improving adherence and reducing hospital readmissions. Almost 30% of patients are non-adherent to their discharge medications seven days after discharge.

WHEREAS, there are a number of specific interventions that can improve adherence, for example ensuring that a consumer’s prescription drug plan covers his or her medicines so the consumer can know if he or she has to pay and, if they have to, can anticipate the cost.

WHEREAS, in order to increase the adherence of medication, new laws and programs should be put in place to prevent changes to coverage and cost sharing to previously covered drugs during the plan year.

WHEREAS, it is necessary to improve the medication therapy management programs, in which patients receive pharmacist counseling on their medication therapies.

WHEREAS, medication synchronization should be improved, that means reducing confusion and improving convenience for the patient.

WHEREAS, it is vital to improve the coordination between a patient’s providers, insurers, and his/her pharmacist.

WHEREAS, for patients on maintenance medication, it is necessary to increase the availability of 90 day fills of medicines to most affectively treat chronic conditions.

WHEREAS, many states have passed legislation to improve the discharge planning process and to encourage involvement of the patient’s caregiver(s) in discharge planning and post-discharge care.

WHEREAS, legislation has been introduced in the United States Senate, that:

• Creates a national research and reporting strategy for improved medication adherence;
• Links Medicare prescription drug to Parts A and B Claims data;
• Recognizes medication therapy as a quality improving program for Medicare Advantage and Part D plans; and
• Extends participation in an existing medication therapy management model to Medicare Advantage-Part D plans.

THEREFORE, BE IT RESOLVED, that NHCSL supports policies that will improve medication adherence, including the state and federal legislative activities referenced above; that encourage patients and providers, including pharmacists, pharmaceutical companies; insurance companies and other stakeholders to engage in activities to educate relevant communities on interventions to improve adherence; and that empower patients to remain adherent to their medication therapies.

BE IT FURTHER RESOLVED, that the NHCSL encourages collaboration with health care providers, companies, and insurers that are truly committed to improve public health, in order to ensure positive health outcomes for patients.

BE IT FINALLY RESOLVED, that a copy of this resolution be transmitted to the President of the United States, the Vice President of the United States, members of the United States House of Representatives, the United States Senate, the Secretary of the Department of Health and Human Services, the Administrator of the Centers for Medicare & Medicaid Services, and other federal and state government officials.

1. Benjamin, R. M. (2012). Medication Adherence: Helping Patients Take Their Medicines As Directed. Public Health Reports, 127(1), 2–3.

2. Express Scripts (2015). The High Price of Low Adherence to Medication. Available at http://lab.express-scripts.com/lab/insights/adherence/the-high-price-of-low-adherence-to-medication

3. Fallis, B. A., Dhalla, I. A., Klemensberg, J., & Bell, C. M. (2013). Primary Medication Non-Adherence after Discharge from a General Internal Medicine Service. PLoS ONE, 8(5), e61735. http://doi.org/10.1371/journal.pone.0061735

4. Senate Bill 3454 (114th Congress).