White paper released at Capitol Hill briefing with Rep. Patrick Meehan (R-PA) & key stakeholders shows 10:1 return on investments in medication adherence
WASHINGTON, DC (October 25, 2017): Prescriptions for a Healthy America (P4HA), the medication adherence campaign of the Council for Affordable Health Coverage, unveiled a white paper advocating for a "safe harbor" to the federal anti-kickback statute that would allow investments in strategies that improve care coordination and medication management.
The policy blueprint entitled "A Treatable Problem: Addressing Medication Nonadherence by Reforming Government Barriers to Care Coordination" was released at a Congressional briefing featuring Congressman Patrick Meehan (R-PA) and industry stakeholders.
"We know that robust medication adherence programs can save lives, contain health care costs, and incent the shift to value-based arrangements. As this white paper notes, the benefits attributed to improved self-management of chronic diseases exceed the cost of medication adherence programs by a ratio of 10:1," said P4HA Executive Director Sloane Salzburg."Despite this, health care providers, plans, and drug manufacturers have been discouraged from developing and carrying out programs to improve patient adherence because of the risk that such programs will implicate the federal anti-kickback statute. There are 28 'safe harbors' that already exist in law for other beneficial purchasing arrangements, yet none explicitly protect adherence programs. This lack of clarity breeds an abundance of caution that favors inaction. As discussed during this morning’s briefing, providers stand ready to deploy adherence programs that can improve patients’ well-being and longevity - they simply need to know Washington won't undermine their efforts."
The white paper notes that, left unaddressed, medication nonadherence may cost consumers and taxpayers $6 trillion over the next decade alone; creating a strain on health care spending roughly comparable to that of smoking and yet only receiving a fraction of the attention. It further reports that medication adherence programs can be a valuable component of value-based purchasing arrangements by ensuring that outcomes are truly based on the efficacy of the medication, rather than the results of improper use.
P4HA argues in the white paper that "A range of stakeholders are interested in providing adherence services to ensure appropriate use of medicines. These efforts are made more difficult by the lack of clear guidance under the Federal Anti-Kickback Statute (AKS), which has limited stakeholders’ comfort with supporting adherence for patients with insurance through Federal healthcare programs such as Medicare and Medicaid ... Creating a narrowly tailored safe harbor for adherence programs would provide clarity to stakeholders who are seeking to implement programs that can improve outcomes for patients and lead to reductions in medical spending."
The full P4HA white paper is available for download here. Proposed legislative language for the adherence safe harbor begins on page 15.
Prescriptions for a Healthy America: A Partnership for Advancing Medication Adherence (P4HA) (www.adhereforhealth.org) was launched in 2013 by the Council for Affordable Health Coverage.P4HA brings together leading patient, physician and health care industry leaders to urge policymakers to implement near-term solutions that will help reduce health care costs and improve the lives of patients across the nation.