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Boost your prescriptions and your patients’ outcomes

In a recent study (Medication Adherence in America: A National Report Card) of Americans age 40 and older who were prescribed medication for a chronic condition, only 24% were fully adherent. Top reasons for not being adherent included forgetting to take their medication, cited by 42% of non-adherent patients, and running out of the medication, cited by 34%.1

Findings from this study suggest that pharmacists can improve medication adherence by:

  • Connecting with patients
  • Explaining the importance of taking medications as directed
  • Helping patients find the most affordable medications for their conditions

Improving Adherence: A Win-Win-Win

When customers take medications as they should, it benefits patients, payers, providers and your pharmacy. Here’s how:

  • Patient outcomes improve. Between one third and one half of all patients don’t take their medications as directed — and those with chronic illnesses, for whom taking their medications is most important, have the worst adherence.2 An estimated 125,000 Americans die each year because of poor medication adherence.3
  • Quality ratings improve for payers and providers. Medication adherence is an important measure for health plans under the new Medicare star ratings system. (See “How Health Plans and PBMs Evaluate Pharmacy Performance.”)
    • For payers (health plans), quality star ratings related to medication adherence affect their bonuses and have the potential to positively affect enrollment rates.
    • For providers, quality ratings affect their ability to participate in preferred networks and have access to patients, as payers will increasingly be basing network participation decisions on providers’ quality ratings. For providers, medication adherence — which is tied to the number of days per year that individuals with chronic diseases have their medications — is an important measure of quality.
  • Pharmacy revenue and profits increase. Patients in one medication synchronization program (highlighted in NCPA research) averaged more than 100 additional days on therapy than those not in the medication synchronization program, meaning 3.4 more 30-day refills for each of the patient’s medications.4 So, the bottom-line implication for pharmacies placing 100 patients on such a med sync program could add $112,000 in revenue and $25,000 in gross margin annually. That’s based on 3.4 refills multiplied by an average of 5.9 prescriptions per patient, resulting in about 20 additional refills per participating patient per year. (The revenue and gross margin figures come from the research report and were calculated using data from the 2013 NCPA Digest.)

Making It Work

Towncrest Pharmacy in Iowa City, Iowa, began offering medication synchronization last November. “We were looking for services that were going to attract people,” said owner Mike Deninger, who has three competing chain pharmacies so close to one store that he says he could drive a golf ball to any of them.

Using its existing pharmacy-management system (PMS), Towncrest is able to flag prescriptions of patients who may not be compliant with medications for conditions such as high cholesterol. Towncrest can tell if a patient was not compliant if they hadn’t picked up a refill on the appropriate timing. When the customer picked up their next prescription, the technician or pharmacist would mention the free service to synchronize medications and schedule pickup dates.

Before filling the prescriptions, the pharmacy calls patients to check exactly what they need. The pharmacy can identify if a prescription is about to expire or if not enough doses are left on the prescription to completely fill it. “We’re taking care of problems before they become problems,” Deninger said.

The pharmacy also is able to synchronize not just a single patient’s medications, but the medications for all of their family members. That means only one pickup or delivery instead of many. (Learn more in “It’s Time to Start Offering Medication Synchronization.”)

In addition to the synchronization program, which is free, the pharmacy also offers compliance packaging for $35 a month, an amount that Deninger notes is a lot less than paying a visiting nurse to manage doses. That program allows some patients to remain independent longer, rather than having to move to an assisted living facility or nursing home.

While he’s still early in evaluating his efforts, Deninger believes that Towncrest may be refilling prescriptions for participating customers one or two more times per year.

Where to Start

Matt Johnson, owner of Chet Johnson Drug in Amery, Wisconsin, hopes to have a new medication synchronization program in place this spring. About 18 months ago his pharmacy began trying to use its existing PMS to manage an auto-fill program but found flaws in the system.

Johnson plans to start offering the program to his customers who are using the pharmacy’s free delivery service, which will save the pharmacy money through fewer deliveries. Then he plans to move forward implementing the medication synchronization program for specific diseases and drugs where it can have the greatest impact.

If you aren’t ready to start a medication synchronization service, there are less intensive ways to boost refills, such as simply reminding customers when they may be due for a refill with an old-fashioned letter or a high-tech app. For example, Shop ‘N Save Food and Drug in Bridgeville, Pennsylvania, recently began sending reminder letters to customers who are on maintenance drugs that had passed their refill date. Pharmacy manager Liz Hoskins said customers have mentioned these reminder letters when ordering and picking up their refills.

Use Technology to Drive Refills

You may pride yourself on the personalized service your pharmacy delivers, but sometimes customers would actually rather not talk to a person. Some actually want to use technology instead.

A 2012 study found that 73% of people would prefer to request prescription refills through a mobile phone.5 That’s not surprising to pharmacies that allow customers to order their refills online.

Mike Deninger of Towncrest Pharmacy noticed about a decade ago that some customers, who asked about email, wanted new ways to communicate with the pharmacy. His pharmacy first built its own online ordering system, which developed a huge following. Because of technical problems with that system, Towncrest recently switched to the Your Pharmacy OnlineSM program from McKesson, which includes a free Health Mart® mobile app that customers can download to their smartphones and other devices.

Chet Johnson Drug also uses Your Pharmacy Online. Customers find the mobile app even easier to use than online ordering through the pharmacy’s website, said Sarah Flanum, store manager at Chet Johnson Drug. Ordering online and through mobile devices “spans the generations,” Flanum said, with users ranging from young parents to seniors.

Making Refills Unforgettable

Research shows that allowing patients to manage their prescriptions online improves medication adherence.6

With Your Pharmacy Online, pharmacies can send notifications to patients, as well as reminders by email or text. Customers who use the Health Mart mobile app can set their own reminders and see their prescription history, along with order refills. “People appreciate the fact that they can set reminders,” Flanum said.

Benefits the Pharmacy Too

Receiving electronic refill orders benefits the pharmacies in two other ways. First, it provides better documentation of what a customer ordered than transcribing a phone call. It also allows a pharmacy to manage its workflow. Customers can include a note with their refill that indicates when they plan to pick up the medication.

Even if customers don’t indicate when they will pick up a prescription, Deninger said, the online orders allow pharmacists to plan to have the medications ready before the customers walk in the door.

Offering online and mobile refills is one way for Deninger’s pharmacies, surrounded by chain stores, to show they are up to date and not just some little mom-and-pop operation. “Giving customers options and the ability to choose what’s best for them is what makes you stand out,” he said.

DISCLAIMER: The information provided here is for reference only and does not constitute legal advice. We make no representations with regard to the content’s comprehensiveness. You are solely responsible for investigating and complying with all applicable laws that govern the operation of your business.
1 “Medication Adherence in America: A National Report Card,” National Community Pharmacists Association, June 25, 2013
2 “Poor Medication Adherence Costs $290 Billion a Year,” Brian Dolan, MobiHealthNews, Aug. 15, 2009
3 “Medication Adherence: A $300 Billion Problem,” Prescriptions for a Healthy America
4 “Assessing the Impact of a Community Pharmacy-Based Medication Synchronization Program On Adherence Rates,” National Community Pharmacists Association, Study results prepared by Ateb, Inc., Dec. 10, 2013
5 “Accenture: Most Patients Want Mobile-Enabled Rx Refills,MobiHealthNews, June 25, 2012
6 “Impact of an Online Prescription Management Account on Medication Adherence,American Journal of Managed Care, March 6, 2012