Non adherence costs us all

adherencePOST SUMMARY: Low levels of adherence are extremely expensive.  The main take home point of a CVS Health study is that we need to look more closely at drug adherence in the community setting, not just for disease management, but for cost containment as well.

Over 8 percent of hepatitis C patients taking Sovaldi are failing to complete their full, 12-week course of drug therapy, a dropout rate roughly four times that observed in clinical trials. By discontinuing the drug, shown to have a 90+% cure rate, these patients (and their insurance providers) are incurring health care costs of $28,000 or $56,000, without knowing if they are rid of the virus.  Whether such patients will have to restart a complete 12-week course of the $1,000 per day pill remains a question for medicine and pharmacy experts. 

The costs of the drug are amplified by the patient population itself. In the U.S., hepatitis C infects between 3.4 to 4.4 million people, with another 0.5 to 1 million among the homeless and incarcerated, according to NHANES data. According to Gilead’s security filings, only about 80,000 patients in the U.S. and Europe have started on the drug, reports Jaimy Lee at Modern Healthcare.


Should insurance companies track patient adherence?  That’s a question that is still open for debate.  Non adherence costs the American health care system billions of dollars, but the reasons for non adherence vary by health condition and patient population.  The drug industry, along with insurers, could benefit from more detailed studies and programs to correct non-adherence.