May 11, 2011 source: Wall Street Journal Health Blog
Public Education and Gene Testing to Improve Medication Adherence
There are tons of reasons why people don’t take the medications they’ve been prescribed, including side effects, cost and complicated drug regimens.
A couple of different approaches to improving adherence are in the news today. The first is Script Your Future, a multi-year public-education campaign spearheaded by the National Consumers League and supported by health-industry companies, government agencies, nonprofits and others.
It’s aimed chiefly at patients with diabetes, respiratory diseases including asthma and cardiovascular disease, all of which affect big swaths of the U.S. population and can be particularly troublesome when not treated correctly. The campaign emphasizes the consequences — such as poor health and quality of life — that can spring from skipping meds.
That may sound obvious — wouldn’t someone with high blood pressure know to take his prescribed medications even if he feels fine? — but the NCL says focus-group research showed that “most patients do not understand their diseases or the consequences of not adhering.”
Attacking a different aspect of the problem is a pilot program announced today by Medco Research Institute, a subsidiary of the pharmacy benefit manager Medco Health Solutions, and AssureRx Health. That company makes the GeneSightRx test, which identifies the genetic variants that affect how a person responds to and tolerates certain psychiatric drugs. (Newsweek wrote about the test last year.)
The thought is that better matching a patient with the antidepressant more likely to work for her — without unpleasant side effects — can improve adherence as well as possibly lower health costs, Felix Frueh, president of Medco Research Institute, tells the Health Blog. The pilot will enroll 2,000 Medco members who are currently taking one of the drugs and who switched or added drugs within the previous three months. They’ll get the test, which involves a cheek swab, and their claims data will be tracked to monitor adherence and subsequent medication-switching.
Those patterns will be compared to data from similar Medco enrollees who didn’t participate in the pilot to see if use of the test is associated with better rates of refilling medications on time and less switching between drugs. Results will likely be available in 18 to 24 months, says Frueh.
He adds that the study will be accompanied by a cost-benefit analysis of using the test. AssureRx hasn’t publicly disclosed GeneSightRx’s price.