Nonadherence a critical risk among patients: Express Scripts Canada

by Leo Almazora01 May 2019

A new report on prescription-drug trends in Canada has found that a majority of Canadian patients are not taking their medications as prescribed by their physicians.

According to the newly released Express Scripts Canada 2019 Prescription Drug Trend Report: Active Management Critical, up to 70% of Canadian patients, depending on the conditions they are being treated for, are not complying with their prescribed drug regimen.

Focusing on different medical conditions, the study found a trend of non-compliance among:

  • 70% of plan members with asthma/COPD
  • 47% of plan members with cancer
  • 45% of plan members with diabetes
  • 45% of plan members with inflammatory conditions such as rheumatoid arthritis, MS and lupus

“In order for medications to work, they must be taken as directed,” said Express Scripts Canada President Dr. Dorian Lo. “Our benefit claims data analysis and other research shows that routinely, patients do not take medications as prescribed. They don't always finish their prescriptions and they regularly miss doses.”

Non-adherence is a problem for most patients regardless of their treatment requirements. But it’s especially acute among those who take more than one medication: the more medications a patient needs, the less likely they are to comply with their prescribed medication regimes. According to data in the report, 44% of patients who take one medication are non-adherent; 58% of those who take two to three medications are non-adherent; and 77% of those on four or more medications were determined to be non-adherent to at least one treatment.

According to Dr. Lo, prescription medication non-adherence is “a real health crisis” with multiple negative implications, including worsening health for patients and wasted spending by patients and drug plans.

“Research tells us that there are many different reasons for being nonadherent, some clinical, some cost-related and some behavioural – so improving adherence requires a highly personalized approach,” he said. “A 'one-size-fits-all' approach does not work.”

To help address the issue, Express Scripts Canada said it offers different forms of targeted support:

  • Channel management – The Express Scripts Canada Pharmacy service allows for lower costs with optimized patient care. That includes home delivery of three-month supplies of regularly used drugs for chronic medical conditions as well as an auto-refill capability;
  • Patient health support – Providing specialized, holistic care for patients to better deal with treatment complexity, which results in lower costs along with improved adherence and outcomes.
  • The Express Scripts Canada Therapeutic Resource Centre program – The program provides pharmacy specialists who offer patient-focused consultation, and helps patients manage chronic diseases as well as the medications prescribed for them.