How payers and pharmacies can improve diabetes adherence


In the field of chronic diseases, Type 2 diabetes ranks high when it comes to the challenges of therapy initiation and non-adherence. Diabetes accounts for $24.6 billion in wasteful and avoidable healthcare spending in the United States, and almost 50% of patients fail to reach glycemic goals. What are the factors contributing to non-adherence among diabetes patients? What can payers and pharmacies do to get these patients to initiate and stay on therapy?

Factors in diabetes therapy non-adherence

The factors that cause diabetes therapy non-adherence can be grouped into three areas: patient, provider, and disease-related. Patient factors include demographics, social determinants, comorbid conditions, beliefs about medication and health, as well as inadequate health literacy.

Provider factors include failing to offer a patient-centered environment that ensures open communication and patient education.

Factors related to the disease or the treatment itself include the severity and duration of the disease, response to treatment, regimen complexity, pain and fear of injections, cost, access to care, and adverse effects.

Overcoming adherence barriers: pharmacies

Studies have demonstrated that one of the best ways pharmacies can address chronic disease non-adherence is through medication therapy management (MTM). A study in The Diabetes Educator compared medication adherence rates and type 2 diabetes health outcomes in a sample of underserved patients with suboptimally controlled type 2 diabetes (HbA1C levels of greater than 7%) who had received pharmacist-directed medication therapy management (MTM), to those who had not received these services. The retrospective review found that the MTM patient group had higher medication adherence rates and better outcomes.

Pharmacies also have an important role in overcoming clinical inertia, defined as the failure of healthcare providers to initiate or intensify therapy when indicated. With the flood of new diabetes medications on the market, more complicated treatment guidelines in light of efficacy and safety issues, and the limited time and resources of healthcare providers, pharmacies can help providers assess the patient and recommend the most beneficial medication, as well as improve patient adherence at a number of key interaction points.

Overcoming adherence barriers: Medicare Advantage Plans

For payers, synchronized medication refill programs have been shown to help diabetes patients increase adherence and provide better outcomes. A study in Health Affairs showed a 13% increase in adherence by Medicare Advantage patients taking part in a pilot refill synchronization program.

Another study in the Journal of the American Pharmacists Association looked at the impact of medication synchronization programs on proportion of days covered (PDC) scores. The study, which calculated the PDC scores of Medicare Advantage patients in a medication synchronization program taking statins, renin-angiotensin-aldosterone system antagonists, and noninsulin diabetes medications, found that PDC score increases were seen with all three medications.

How AI improves diabetes adherence

For both Type 1 and Type 2 diabetes, there are artificial intelligence (AI) tools being used widely for patient education and self-management. AI is being used to manage exercise, guide insulin injections, and monitor blood sugar and diabetes complications.

AllazoHealth’s advanced AI technology, which can predict which patients are likely to be less adherent to their medications, was proven in a randomized controlled study with Blue Cross Blue Shield of North Carolina to have 97% predictive accuracy, a 5.5x greater adherence uplift, and 23% less spent on interventions. The study compared targeted vs. nontargeted interventions for 104,392 Medicare Advantage Part D patients, including those with diabetes.

About AllazoHealth

AllazoHealth uses artificial intelligence to make a positive impact on individual patient behavior. We optimize medication adherence and quality outcomes for pharmaceutical companies, payers, and pharmacies. Our AI engine targets individual patients with the right intervention and content at the right time.

Building on our success in adherence, we have expanded our implementation of AI to include closing gaps in care and improving therapy initiation.

Case Study: Leading national pharmacy achieves 2.3x greater uplift in patient fill rate

Learn how AllazoHealth used AI to help a national pharmacy improve cost efficiency for their patient interventions.

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