Medication
adherence across disease states is generally poor. Research has
focused on various methods to improve medication adherence, but
there is little conclusive evidence regarding specific methods
efficacy. The Transtheoretical Model for Behavior Change has been
used to modify existing addictive behaviors but not in medication
adherence specifically. As a behavioral component is inherently
related to medication adherence, it is thought that this model
may be applicable.
Objective: The purpose of this research is to evaluate the costs
and savings of implementing a novel behavioral intervention against
the cost of poor medication adherence to determine whether further
development is realistic.
Methods: The basic tools required to administer this intervention
were determined through primary literature review and priced by
vendors supplying such materials. Diabetes Mellitus Type 2 (DM2)
was used as a vehicle to establish the cost of care for long-term
complications of a chronic disease. The primary literature provided
information regarding the cost of care for DM2 morbidity and outpatient
annual drug therapy expenditure. The total cost of the behavioral
intervention components and the cost of care for DM2 morbidity
were applied to a theoretical cohort of 1000 patients. By dividing
this cost across 1000 patients, a per-patient cost was yielded
and multiplied over a 16-year timeframe.
Results: It was found that the cost to implement the behavioral
intervention and resultant medication costs is USD13,574 per-patient
over 16 years. The cost to treat complications of diabetes mellitus
is USD 36,528 per patient over the 16 years. The total amount
of healthcare dollars potentially saved by utilizing this intervention
is USD 22,954 per-patient.
Conclusions: It appears that the cost to implement this behavioral
intervention is reasonable and permits further evaluation in other
chronic conditions with notoriously poor adherence levels.
