CVS Caremark Publishes State of the States: Adherence Report

WOONSOCKET, R.I., March 27, 2012 /PRNewswire/ -- CVS Caremark today issued two new reports that highlight research the company is conducting around medication adherence, including one study that reviews and compares state-by-state adherence rates for patients managing four chronic diseases.

"These reports are part of our continuing effort to shine a bright light on the issue of adherence so that patients, pharmacists, physicians and policy makers understand why patients taking their medications as directed can improve the quality and lower the cost of health care," said Helena B. Foulkes, executive vice president and chief health care strategy and marketing officer of CVS Caremark. 

The State of the States: Adherence Report is a first-of-its kind study that looks at how patients in all 50 states are complying with their doctors' orders about taking medication. The review of CVS Caremark's pharmacy benefit management claims data focused on four common disease states - hypertension, high cholesterol, diabetes and depression - diseases that make up a large portion of pharmacy spend by health plan sponsors.

The second report, Advancing Adherence and the Science of Pharmacy Care Volume 2,  is a compendium outlining research resulting from a collaboration CVS Caremark has been conducting with Harvard University and Brigham and Women's Hospital over the past three years to explore why a significant portion of patients do not take their medications as directed.

Troyen A. Brennan, MD, MPH executive vice president and chief medical officer of CVS Caremark, who heads the research initiative, said "The research we have been conducting provides important information to those looking for ways to make the health care system more affordable and accessible. Medication adherence is unique because it gives us a real opportunity to improve patient health while lowering the overall cost of care."

State of the States: Adherence Report:

  • Reviews de-identified data from the CVS Caremark pharmacy benefit management book of business across all 50 states to see how patients in different geographies (and potentially different plan designs) are complying with their doctor's directions about taking medications.
  • Examines claims data for four common chronic diseases - hypertension, high cholesterol, diabetes and depression. These four diseases were reviewed because more than half of U.S. citizens suffer from at least one chronic disease, and the treatment for chronic disease represents more than 75 percent of our nation's health care costs.
  • Applies a definition of adherence that weighs medication possession ratio (MPR), first fill persistency rates (FFPS), the percent of generic prescriptions dispensed and the percent of prescriptions that are dispensed through mail. Weight is applied to generic dispensing rates because several CVS Caremark research studies have found that the cost of medications is a consistent barrier to medication adherence. Weight is applied to mail order dispensing rates because CVS Caremark and other research has found that once pharmacies get patients past the important transition of people moving from retail to mail, patients using mail order have higher adherence rates.

Foulkes said, "We plan to share the State of the States: Adherence Report widely, with state and regional officials and directly with policy makers in all states.  We will also use this information to inform discussions we have with our clients about identifying ways to improve adherence rates for their plan members. We hope by convening these discussions around adherence we can convince policy makers to make the goal of improving medication adherence a national priority."

Advancing Adherence and the Science of Pharmacy Care, Volume 2:

  • Outlines findings from 20-peer reviewed articles in medical, pharmacy care and economic journals on different aspects of adherence.  The studies include recommendations for changing health care practices that can improve patient medication-taking behaviors.
  • Summarizes research that discusses the financial impact of adherence, contributing factors to non-adherence, the role of health care professionals in working with patients to improve medication-taking behavior and the role technology can play in improving patient care.

"Our investment of money and time researching this issue is significant. We have brought the nation's top research talent to the task," Brennan said. "The work is helping us engage patients to help them make appropriate decisions about their health. We are also using it to educate the public about the importance of staying adherent to prescription medications."  

The issue of medication non-adherence is a major public health issue. Experts place the annual excess health care costs resulting from medication non-adherence in the United States to be $290 billion.

Brennan said the research to find solutions through research will continue. CVS Caremark intends to share results from the collaboration so providers can develop tools to predict and target those patients who are at risk for non-adherence and prescription abandonment. The future work will focus on finding appropriate pharmacist interventions that will improve care mechanisms that will help health care providers simplify regimens for those with the most complex therapies, improve pharmacist and health-care-provider communications with patients. In addition, Brennan said, the research will also look at social networks as health care tools, patient safety issues, comparative effectiveness, and ways to simplify patient medication regimens, all work at improving patient medication-taking behavior.

Copies of both reports, an interactive map with state-by-state information, and videos on the topic of adherence, and other related information are available at

About CVS Caremark
CVS Caremark is the largest pharmacy health care provider in the United States with integrated offerings across the entire spectrum of pharmacy care. We are a pharmacy innovation company, uniquely positioned to engage plan members in behaviors that improve their health and to lower overall health care costs for health plans, plan sponsors and their members. CVS Caremark is a market leader in mail order pharmacy, retail pharmacy, specialty pharmacy, and retail clinics, and is a leading provider of Medicare Part D Prescription Drug Plans. As one of the country's largest pharmacy benefits managers (PBMs), we provide access to a network of more than 65,000 pharmacies, including more than 7,300 CVS/pharmacy® stores that provide unparalleled service and capabilities. Our clinical offerings include our signature Pharmacy AdvisorTM program as well as innovative generic step therapy and genetic benefit management programs that promote more cost effective and healthier behaviors and improve health care outcomes. General information about CVS Caremark is available through the Company's website at