Common habits such as forgetfulness and procrastination cost the United States an estimated $163 billion in pharmacy-related waste each year, according to the Express Scripts’ 2009 Drug Trend Report.
The study examined changes in drug spending on a year-to-year basis and details the costly effects of irrational behaviors on pharmacy-related costs. St. Louis-based Express Scripts, a pharmacy benefit manager, has produced the Drug Trend Report for 14 years.
"The good news is that these potential savings in the pharmacy benefit are tied to one of the few variables in healthcare we can readily influence: behavior," said Steven Miller, MD, senior vice president and chief medical officer at Express Scripts. "This research shows that in terms of achieving lower costs and improved outcomes, healthcare reform starts in the home."
"If we optimized every individual's behavior relating to prescription drugs, we could achieve savings that in five years would cover the projected costs of the recently passed national healthcare reform legislation," he said.
The $163 billion in wasteful spending comes from three key factors:
- $106 billion from medical costs of non-adherence to therapy.
- $51 billion in missed opportunities related to lower-cost medication alternatives, both brand and generic.
- $6 billion in missed opportunities related to lower-cost options for delivery of medications.
Overall, drug spending in the United States increased 6.4 percent in 2009, reversing a pattern of lower drug trend increases in previous years. Market forces drove the trend up by 8.3 percent, while behavior drove the trend down by nearly 2 percent.
For example, with traditional prescription drugs, Express Scripts clients saved $1.4 billion through the increased use of generics and lower-cost brands. More than of half of that amount, $790 million, came from Express Scripts' behavior-centric programs in partnership with clients. Those savings surpassed some market factors that also helped hold down spending, such as the expiration of branded patents, which allows development of lower-cost generic drugs.
According to the study, diabetes is the top driver of total cost increases in the traditional drug sector because of growth in use and cost per prescription. Spending for drugs used to treat viral infections increased by approximately 25 percent, primarily because of increased use for agents used to treat influenza.
"We have good cause for optimism that the behaviors causing this vast waste in healthcare can change,” said Bob Nease, chief scientist at Express Scripts.