IMS Health study: Up to 15% of healthcare system costs avoidable and effective patient activation by multiple stakeholders is key to driving improvement.
Low levels of adherence and persistence remain barriers to reducing the costs associated with type 2 diabetes (T2D) in the United States, according to a report by IMS Institute for Healthcare Informatics.
Improving Type 2 Diabetes Therapy Adherence and Persistence in the United States, is part of a publication series that examines 6 diverse healthcare systems around the world to determine their recognition of T2D as a public health priority. In addition to the U.S., the series also looks at the effect of T2D in Brazil, Germany, the Kingdom of Saudi Arabia, Mexico, and the U.K.
According to the report, direct diabetes spend is currently exceeding $100 billion among the senior population in the U.S., with about $4 billion attributed to poor adherence (the extent to which a patient follows the prescribed interval and dose of a drug regimen) and persistence (the time from initiation to discontinuation of therapy). Furthermore, the prevalence of T2D is on the rise in the U.S. with 17.2 million seniors expected to be diagnosed with the condition by 2025.The rising prevalence of Type 2 diabetes and its associated complications is the root of considerable strain on society and an economic burden on healthcare systems,” said Murray Aitken, IMS Health senior vice president and executive director of the IMS Institute for Healthcare Informatics, in a press release. “Simple, customized interventions that put patients on the path to optimal adherence and persistence can yield tangible results, but require alignment between healthcare and government leaders, as well as the active involvement of voluntary associations and the private sector.”
In order to estimate potential reductions in T2D costs for each country’s health system, researchers used IMS Health’s CORE Diabetes Model, customized to reflect average levels of adherence and persistence. Results showed that on average, less than 40% of individuals with T2D globally are achieving optimal levels of adherence and persistence; and that by improving these aspects of care, health systems can reduce costs of diabetes complications by 4% to 15%.
To improve adherence and lower healthcare costs associated with T2D, IMS researchers recommend focusing on enhanced patient activation, defined as how well a person understands his or her role in the care process and whether that person has the knowledge, skills, capacity and confidence to follow through with this role. Activation is composed of five interrelated elements, including health beliefs and attitude, personal circumstances, health status, health literacy, as well as access and affordability. Together, these factors determine an individual’s willingness and ability to take actions to manage their own health.
The report also proposes a set of practical recommendations to raise the levels of adherence and persistence in patients with T2D. A few of these recommendations include identifying and profiling patients in need of help, improving access to customized education materials, and using digital technology to maintain effective disease self-management.