Medication Adherence and Measures of Health Plan Quality

Seth Seabury, Darius Lakdawalla, Samantha Dougherty, Jeff Sullivan, and Dana Goldman analyzed the association between plan-level measures of health outcomes and medication adherence to determine whether adherence was a viable measure of insurance plan performance. The researchers analyzed medical and pharmacy claims from a database of large private employers from 2000 to 2009. The researchers compared the plans of patients who took their medications for prescribed drugs for diabetes and CHF at least 80 percent of time compared to plans whose patients didn’t have good adherence. Seabury and his colleagues found patients with these chronic conditions are only taking medications about half the time; rates for common therapies for diabetes ranged from 45.2 to 56 percent while the range for CHF medications was 37 to 51.2 percent.  Overall the researchers found plans with low adherence to diabetes medications had adjusted rates of uncontrolled diabetes admissions of 13.2 per 1000 patients, compared with 11.2 in moderate adherence plans and 8.3 in high adherence plans. A similar pattern followed for patients with CHF.

The full study is available at AJMC.

Citation: Seabury, S. A., Lakdawalla, D. N., Dougherty, J. S., Sullivan, J., & Goldman, D. P. (2015). Medication adherence and measures of health plan quality. The American journal of managed care21(6), e379-89.