Publish Date: March 15, 2023
Author: Thomas Zimmerman
Tags: Blog - SeubertU

Increasing Cost of Drugs and the Impact on Medication Adherence

Provided by Thomas Zimmerman III, CEBS

The increasing cost of prescription medications has become a major concern for patients and healthcare providers worldwide. The high cost of medications has resulted in decreased patient adherence, which in turn has increased healthcare costs and led to serious health consequences. Patients with chronic conditions like diabetes, hypertension, and heart disease are the most affected by rising medication costs as they require long-term medication use.

One of the most significant impacts of rising medication costs is decreased patient adherence. When patients cannot afford their medications, they may skip doses or delay refilling their prescription, leading to serious health consequences. This can increase healthcare costs, as patients may require additional medical attention and treatments to manage their health conditions.

To address the impact of rising medication costs on patient adherence, several potential solutions can be explored. One solution is to increase access to generic medications, which are often much less expensive than brand-name drugs. The Affordable Care Act mandated coverage of preventive care which includes certain preventive medications at $0 patient cost through healthcare. These lists of ACA preventive medications are the starting point. Many pharmacy benefit managers can expand upon these lists and include additional preventive maintenance medications (including Insulin) at $0 patient cost, but these expansions are optional and must be elected.

Another potential solution is to explore alternative payment models for prescription medications, such as discount programs like GoodRx and Cost Plus Drugs. These programs may provide savings to patients, but it is important to note that prescriptions filled through alternative programs will not have their costs applied to deductibles or out-of-pocket maximums under a healthcare plan.

Employers can also leverage claims data analytics technology to monitor patient adherence and look for educational and intervention opportunities. Pharmacist advocates can reach out to patients and providers to encourage adherence and reduce negative outcomes.

Finally, increased transparency in drug pricing could also help to address the rising cost of prescription medications. Providing education on tools and resources to identify pricing and pricing changes can help patients and healthcare providers make more informed decisions about which medications to prescribe and use. 

In conclusion, rising medication costs have become a significant challenge impacting patient adherence and health outcomes. To address this issue, it is crucial to explore potential solutions that increase access to generic medications, explore alternative payment models, monitor adherence, and increase transparency in drug pricing. Working together to address the impact of rising medication costs can ensure that patients have access to the medications they need to manage their health conditions and improve their quality of life while optimizing healthcare costs. 


Contact our risk consultants today to learn how these strategies can minimize your business’s Rx costs.