The Workplace Costs of Not Taking Your Medication
Peter Geppert and Ryan Zayance
Master’s Students in Health Management and Policy
October 1, 2018, Health Management and Policy, MHSA, Students, Chronic Disease, Disability, Health Informatics, Pharmaceuticals, Research, Statistics, Value-Based Care
How much money does it cost not to take your medication?
Approximately $940 per person according to research we published as researchers at the University of Michigan Center for Value-Based Insurance Design (V-BID) in collaboration with the Integrated Benefits Institute (IBI). Our study explores the impacts of medication nonadherence on worker productivity and seeks to demonstrate the value of interventions that help people with chronic illnesses follow the clinical guidelines associated with their prescribed medication.
We estimate that employers can significantly benefit from the treatment adherence of their employees with diabetes.
Many chronic clinical conditions have elaborate and costly treatment protocols, making nonadherence—not taking prescribed medications—common among those affected. In a review of 13 peer-reviewed articles, we found mixed results in the relationship between nonadherence and diminished work productivity. However, consistent evidence showed a relationship between adherence and reduced disability leave days in employees diagnosed with diabetes. If people with diabetes are able to receive treatment consistently, they may be less likely to miss work due to illnesses unrelated to work.
Employees with chronic diseases are not the only beneficiaries of treatment adherence. We estimate that employers can significantly benefit from the treatment adherence of their employees with diabetes. By our estimation method, if treatment adherence in a group of 1,000 employees with diabetes collectively improves by just 10 percent, short-term disability days and lost work time could be reduced by as many as 441 work days and save the employer approximately $94,000.
Several factors can contribute to medication nonadherence, including treatment cost, transportation ability, and patient forgetfulness. Companies with large groups of employees living with one or more chronic illnesses may derive a significant financial benefit from working with insurers to develop programs directed toward addressing the factors contributing to those employees' nonadherence to treatment.
One program that has proven to be effective in improving adherence is value-based insurance design, which lowers financial barriers to care by assigning the price of treatment based on its clinical value. A recent Health Affairs review of V-BID programs demonstrated enhanced medication adherence without an associated increase in total health care spending. Tailored phone messages reminding people to take medication have also shown promise in improving adherence for people with chronic illnesses.
Our findings suggest not only that employers have a legitimate incentive to invest in programs that help their workers adhere to clinical guidelines, but that doing so can help improve the value of the dollars we spend on health care as a nation. Future studies on medication nonadherence can further assess this question and guide future efforts to improve the efficiency of national health spending.
About the Authors
Peter Geppert is pursuing a Master of Health Services Administration degree and is a student researcher at the University of Michigan’s Center for Value-Based Insurance Design. He spent this past summer in a placement in Massachusetts General Hospital’s perioperative services division. He has worked at Epic Health Systems in Verona, Wisconsin, as an implementation consultant on the company’s physician billing software, completing revenue cycle installs at the University of Rochester Medical Center and Regional Health.
Ryan Zayance is a second-year student in the University of Michigan School of Public Health, where he is working toward his Master of Health Services Administration degree. He is a graduate research associate with the Center for Value-Based Insurance Design and serves as a committee chair for two student organizations. Ryan is interested in operational process improvement and turnaround financial management in hospitals and health systems, as well as innovations in healthcare insurance markets and reimbursement strategies.