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Medication non-adherence and poor compliance have significant health and economic consequences in the United States:

## Health Impact

- Non-adherence contributes to approximately 125,000 potentially preventable deaths annually[3].

- It can lead to worsening symptoms, disease progression, and increased hospitalizations[1].

- For patients with mental illness, non-adherence is associated with higher rates of suicide, unemployment, and homelessness[1].

## Economic Impact

- The total cost of medication non-adherence is estimated to be $528.4 billion to $672.7 billion annually[2][3].

- This represents about 16% of total U.S. healthcare costs[3].

- Non-adherence leads to increased healthcare utilization, including more frequent doctor visits and hospitalizations[1].

## Factors Contributing to Non-Adherence

- Cost is a primary factor - nearly 1 in 4 Americans report difficulty affording their prescription medications[1].

- Prescription abandonment rates rise significantly as out-of-pocket costs increase:

 - 5% when there is no out-of-pocket cost

 - 45% when cost is over $125  

 - 60% when cost exceeds $500[3]

## Potential Solutions

- Implementing caps on out-of-pocket prescription costs

- Spreading cost-sharing obligations more evenly throughout the year

- Expanding programs like the Low-Income Subsidy Program

- Improving price transparency and access to lower-cost alternatives

- Addressing social determinants of health that impact adherence

Improving medication adherence has the potential to significantly reduce healthcare costs while enhancing patient outcomes and quality of life. Addressing the affordability of prescriptions appears to be one of the most effective ways to improve adherence rates.

Citations:

[1] https://www.magellanhealthinsights.com/2024/02/19/prescription-predicament-the-impact-of-rising-drug-costs-on-medication-adherence/

[2] https://www.panfoundation.org/medication-non-adherence/

[3] https://www.psqh.com/analysis/the-impact-of-cost-on-medication-adherence/

[4] https://www.ajmc.com/view/contributor-medication-adherence-is-not-a-zero-sum-game

[5] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7735208/

[6] https://www.cms.gov/files/document/mcbs-nonadherence-brief-2019-04-25pdf

[7] https://www.cdc.gov/pcd/issues/2020/20_0244.htm

[8] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10196872/