Medication Adherence and Medicare Expenditure Among Beneficiaries with Heart Failure

Hospitalization rates and Medicare costs due to cardiovascular disease have the potential to be reduced when patients practice better medication adherence. Here, the authors present their findings on the relationship between adherence to congestive heart failure (CHF) medication and Medicare expenditure.

Models were set up using six cohorts of three years each (N=2,204). Beneficiaries with CHF were selected using the Medicare Current Beneficiary Survey and were followed using computer-assisted, in-person interviews from 1997 through 2005. The four major drug groups studied included angiotensin-converting enzyme inhibitors or angiotensin II receptor blockers, beta-blockers with approved indications in heart failure, diuretics, and cardiac glycosides. Medication adherence was calculated using average daily pill counts over each three year observation.

Key Findings:

  • Over the three-year study period, Medicare beneficiaries with better medication adherence were associated with lower cumulative Medicare spending.
  • Results showed that a modest 10 percent increase in daily pill counts for cardiac glycosides yielded $1,244 savings in Medicare cost. The result was statistically significant.

Of the patients not taking medicines in this study, it could not be determined if patients were not filling their prescribed medicines or if they were not being prescribed appropriate medication. Further research will help unveil the underutilization of drug therapy.