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90-Day Fills for Medicare Patients - We Need Your Help!

June 10, 2015

In partnership with CareOregon Advantage, you can help our Medicare patients maintain adherence to their current medications for chronic diseases such as hypertension, diabetes, heart failure, COPD, depression, and hyperlipidemia. How? By switching our Medicare patients who are on 30-day fills of maintenance medications to 90-day fills in the community pharmacy setting.

90-day fills for maintenance drugs are a covered benefit under our Medicare plans. To help combat the higher frequency of patient pharmacy trips and to improve adherence, we ask that whenever clinically appropriate, you prescribe maintenance drugs to CareOregon Advantage patients at the 90-day quantity.

Recently, we partnered with OutcomesMTM®, a national leader in the design, delivery and administration of Medication Therapy Management program, to kick start an adherence monitoring program. Pharmacists will enroll our Medicare patients and check in with them every three months to see how they are doing, as well as motivate them to be adherent. The help of our Rx prescribers vastly improves what this program can do for our Medicare patients.

Here are some interesting studies on prescription drug adherence and 90-day fills.

According to the Centers for Disease Control (CDC), patients fail to continue medications as prescribed 50% of the time. Those that are written but never filled are about 20-30%. In the United States, it is estimated that:

  • Rates of medication adherence drop after the first six months
  • Only 51% of Americans treated for hypertension are adherent to their long term therapy
  • About 25%-50% of patients discontinue their statins within one year of treatment

The burdens of non-adherence:

  • Approximately 30% to 50% of treatment failures and 125,000 deaths annually
  • Non-adherence to statins increased relative risk for mortality by 12% to 25%
  • Non-adherence to cardioprotective medications increased the risk of cardiovascular hospitalizations (10%-40%) and mortality (50% to 80%)

A study conducted by Khandelwal N, et al, and published in the American Journal of Managed Care found that on a propensity-matched basis, patients who fill maintenance drugs at retail pharmacies have a statistically significant higher adherence than those who fill by mail.