Small Proportion of Prescriptions Are Abandoned

New medication users, those with higher copays more likely to abandon prescriptions

TUESDAY, Nov. 16 (HealthDay News) -- Prescription abandonment accounts for a small proportion of drug non-adherence, with prescriptions with higher copayments, those for new medication users, and those delivered electronically more likely to be abandoned, according to research published in the Nov. 16 issue of the Annals of Internal Medicine.

William H. Shrank, M.D., of the Brigham and Women's Hospital in Boston, and colleagues analyzed data from the CVS pharmacy chain and insurance claims data from Caremark, a pharmacy benefits manager, on more than 5.2 million individuals who filled more than 10.3 million prescriptions.

The researchers found that 3.27 percent of prescriptions were abandoned -- that is, not picked up. For nearly half of these, patients bought a prescription for a drug from the same class at a pharmacy in the next 30 days. New medication users had a 2.74 times greater chance of abandonment than prevalent users. Prescriptions that were electronically delivered were 1.64 times more likely to be abandoned. Copayments of $40 to $50 and prescriptions that cost more than $50 were 3.40 and 4.68 times more likely, respectively, than prescriptions without copayments to be abandoned.

"As Shrank and colleagues note, physicians are often unaware of the patients' out-of-pocket costs. This information is available in many pharmacy systems, and better physician-pharmacist collaboration surrounding medication choice could increase adherence. Perhaps tools for such collaboration could be a new element of electronic prescribing programs," write the authors of an accompanying editorial.

CVS Caremark provided funding for the study. Several authors disclosed relationships with CVS Caremark and/or other commercial interests.

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