“Ready for Pick Up: Reducing Primary Medication
Non-Adherence – A New Prescription for Health Care Improvement,”
outlines the problem of
prescriptions for newly-initiated therapy that are not picked up for the first time and, thus,
never taken, leading to the possibility of worse health and increased stress on the health care
system. The rate of primary non-adherence (PMN), that is, the percentage of first-time
prescriptions abandoned by patients (and thus not picked up at pharmacies), can range as high as 30
percent among some classes of medication, according to recent research.
A May 2014 working group convened by the National Association of Chain Drug Stores (NACDS)
Foundation, the Pharmacy Quality Alliance (PQA), and NEHI framed the issues outlined in the paper.
The paper addresses key issues in the adoption and utilization of a new pharmacy quality metric on
primary medication non-adherence endorsed by the Pharmacy Quality Alliance in November 2013. Prior
to the advent of e-prescribing, tracking PMN rates was not feasible. Current adherence policy
focuses on patients who have received their therapies at least once – because these patients
trigger payment claims processing that allows medication adherence to be tracked.
The report makes eight recommendations that stakeholders, from physicians and pharmacists to
insurers and health plans, could do to understand and attack the problem, including pharmacist
interventions with non-adherent patients.
High on the list: more dialogue among health care payers, the physician community and the pharmacy
industry to establish common ground for action.