The topic is consumer medication information (CMI). A new report from the American Medical
Association (AMA) Council on Science and Public Health reminds us why it’s important for patients to take medications as
prescribed. Here’s why it matters.
• Nearly 75% of Americans admit they don’t always take the medications they’re prescribed;
• 33% of prescriptions go unfilled;
• About $0.75 of every US healthcare dollar is spent treating chronic diseases; and
• Only 50%-65% of patients take medications as prescribed.
Noncompliance leads to greater health concerns, both physically and fiscally:
• Noncompliant patients are more likely to be hospitalized;
• They’re more likely to die;
• And while they live they have almost twice the annual health cost compared with people who adhere to their medication regimen.
Not taking medications as prescribed means medication-related hospital admissions, which cost an estimated 100 billion dollars each year. All in all, this totals additional healthcare costs of nearly 300 billion dollars each year. That’s 13% of total health expenditures.
One possible explanation of this lack of compliance is lack of information, thus patients misunderstand the importance of taking medications as prescribed. So the AMA Council on Science and Public Health took a closer look at the types of CMI currently available.
The concept of CMI began in 1968 when the FDA first required patient package inserts (PPIs). In the 1970s, the FDA shifted its focus to patient labeling. The 1990s saw FDA-approved medication guides (Med Guides) for some high-risk drugs. Then congress stepped in and passed legislation with caveats and goals that became the action plan for the provision of useful prescription medication information. By the year 2000, 75% of people receiving new prescriptions were to get useful
information. By 2006, this percentage was to increase to 95%. The law required the Department of Health and Human Services to review initiatives to meet these goals.
Unfortunately, the FDA reports that current consumer information processes have failed. Although patients got information 94% of the time, only 75% of that information was deemed useful. This required an FDA overhaul of the current system for CMI.
In 2008, a citizen petition submitted to the FDA called for adoption of a one-document solution to replace the plethora of CMI, PPI, and Med Guides. Providing information to patients in a forum that’s concise, balanced, and understandable should improve medication adherence but such materials must be based on user testing. The AMA supports single-document CMI. It should be easily accessible and also available in electronic formats. Easy access to these tools should help enhance medication understanding and adherence. It should also provide patients with the information they need to use medications safely and effectively, but even the best information won’t help if people can’t afford to buy their medications in the first place.
By Sandra A. Fryhofer, MD
Medscape Internal Medicine