CVS Caremark Study Compares Adherence Metrics By State and Region

Among all the states, New Jersey patients in Medicare Part D prescription drug plans are the most persistent in filling first-time prescriptions, with a 94.2% fill rate.
Health plans and employer-sponsored plans in Minnesota reach the highest generic dispensing rates, at 93.4% and 92.4% respectively.
And across all market segments (health plans, employer-sponsored plans, and Medicare Part D plans) patients with depression generally have the lowest adherences rates, while patients with hypertension are the most adherent.
These are some of the findings of the second annual State of the States report, an overview of adherence rates, from CVS Caremark.  Drawing on data from CVS Caremark’s pharmaceutical benefit management (PBM) business, the report for the first time analyzes results by market segment to show differences across the pharmacy benefit marketplace.
Additionally, audiences can filter data based on market segment, health condition, and adherence measure, and compare the results by state at an interactive on-line hub developed in conjunction with the report:
“This data offers policy makers and the health care industry a new look at adherence across geography, health condition, and prescription insurance status, and demonstrates the need for increased adoption of interventions that can improve medication adherence in order to advance health outcomes for patients and lesson the cost burden for the health care system,” said Troyen A. Brennan, MD, executive vp and chief medical officer of CVS Caremark.
The report describes adherence rates and the use of generic drugs across four conditions: diabetes, hypertension, depression, and high cholesterol (dyslipidemia).
Adherence measures are broken out by state for each market segment. Measures include patient rates for first-fill persistency and medication procession ratio (MPR,  “the ratio of the days the member had the drug available to the number of possible days the member could have the drug on hand”). The percentage of 90-day scripts, and the generic dispensing rate are also tracked.
Among overall trends:
--Medicare beneficiaries had the highest adherence rates across all three market segments.
--Ninety –day dispensing rates were generally highest among members of employer-sponsored plans.
--Regional variations include, in the Midwest, the lowest adherence rates for health plan members with diabetes and depression;  in the South, the lowest rates for patients with any condition in employer-sponsored plans and Medicare Part D.
The report in addition includes information on potential state-by-state cost savings if adherence measures such as MPR and generic drug substitution were developed to optimal levels.
In hand with the 2013 State of the States report, the CVS Caremark Pharmacy Care Research Institute has also released Advancing Adherence and the Science of Pharmacy Care: Volume III, a compendium of adherence research of the past several years.
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