Contributed Commentary by G. Cameron Deemer

April 30, 2019 | Medication nonadherence leads to poor health outcomes, higher costs, frustrated providers, and needed medications left on the shelf. Prescription abandonment is a frequently overlooked factor of medication non-adherence. The problem is particularly acute with new prescriptions, as 20 to 30% of “first-fill” prescriptions are never filled, according to the U.S. Centers for Disease Control and Prevention. Overall the CDC estimates that non-adherence is responsible for 30 to 50% of chronic disease treatment failures and 125,000 deaths per year in the U.S.

Cost is the most reliable predictor of prescription abandonment, according to a study in the Annals of Internal Medicine. Researchers found that prescriptions with a cost over $50 were almost five times more likely to be left at the pharmacy than those with no co-payment, while medications with a co-payment between $40 and $50 were 3.4 times more likely to be abandoned than those with no co-payment.

The key to reversing the trend may be the mobile devices in our pockets and purses. Mobile medication management solutions enable physicians to better engage patients by providing real-time benefits like medication information at the point of care and facilitating discussions about out-of-pocket costs. This helps to solve the problem of first-fill abandonment, increasing the likelihood patients will pick up their prescriptions in a timely manner.

Studying the Most Significant Drivers of Abandonment 
There are multiple factors that may cause patients to abandon prescriptions, including unclear instructions, forgetfulness, multiple medications with different regimens, unpleasant side effects, and/or perceived ineffectiveness. Following are three issues we believe to be significant drivers of prescription abandonment—all of which can be resolved by a mobile patient engagement platform:

-Financial barriers: To manage the out-of-pocket cost of medications, patients need access to insurance co-pay information, as well as drug manufacturer’s coupons and prescription discount cards.

-Lack of clinical information:  To facilitate greater understanding regarding the rationale for the medication and/or treatment, patients need access to relevant educational materials.

-Procrastination: To overcome the tendency to delay, or forget to pick up a prescription, patients benefit when able to schedule pick-up at the pharmacy.

To test the impact of a mobile patient engagement platform on first-fill prescription rates, we developed a study in conjunction with life sciences market research firm KMK Consulting. Our study evaluated the effects of delivering real-time, personalized, relevant information on prescription abandonment to patients’ mobile devices and compared the results from this group with a control group that received no notifications. The study examined approximately 500,000 patients who received e-prescriptions.

Greater patient engagement, higher fill rates

The results illustrate the considerable potential of mobile patient engagement platforms to increase fill rates. The results showed:

- 11% increase in fill rates for patients who saw the notification but did not engage with the platform.

- 23% reduction in first-fill abandonment for patients who accessed educational materials, received discount information, or scheduled a pharmacy pickup.

- 60% of patients who received a notification engaged with the platform shortly after visiting their providers.

- 97% of patients who engaged with the system were satisfied with the experience.

These results are striking in that they highlight the effect of sharing the right information with the right patient at the right time on prescription fill rates. By empowering patients to overcome medication abandonment barriers like financial issues, lack of clinical information and procrastination, mobile medication management platforms drive better health at the point-of-care.

G. Cameron Deemer serves as DrFirst’s president and brings more than 20 years of healthcare industry experience to this position. He joined DrFirst in 2004 as the director of product management before being appointed general manager in 2005 and president shortly thereafter. Since joining DrFirst, Mr. Deemer has played an instrumental role in formalizing and driving improved business processes, while developing new technology strategies to leverage the benefits of e-prescribing and other DrFirst platform services for providers, hospitals, payers, and other healthcare stakeholders. He can be reached at cdeemer@drfirst.com.