IMS study: $213B linked to medication misuse

About $213 billion, or 8 percent of the U.S. healthcare industry’s total annual healthcare expenditures, are incurred due to failure to use medicines responsibly, according to a study published by the IMS Institute for Healthcare Informatics.

Medication nonadherence, delayed evidence-based treatment practice, misuse of antibiotics, medication errors and suboptimal use of generics and mismanaged polypharmacy in older adults all contribute to these avoidable costs. These areas lead to unnecessary utilization of healthcare resources involving an estimated 10 million hospital admissions, 78 million outpatient treatments, 246 million prescriptions and four million emergency room visits each year, the study found.

“Those avoidable costs could pay for the healthcare of more than 24 million currently uninsured U.S. citizens. Reaching a meaningful level of consensus and alignment among stakeholders, based on measured and proven success models, is a key step to unlocking the $200 billion opportunity identified in our study,” said Murray Aitken, executive director, IMS Institute for Healthcare Informatics.

The study brings to light some progress in bringing down these costs. Programs that foster greater medical adherence among patients with hypertension, hyperlipidemia and diabetes, as well as efforts to prescribe fewer inappropriate antibiotic prescriptions for patients diagnosed with a cold or the flu, all indicate positive changes. Greater use of lower-cost generic drugs also received mention.

Study findings include:

• Medication nonadherence, the largest avoidable cost, accounts for an estimated $105 billion in annual avoidable healthcare costs. Growing use of analytics and collaboration among providers, pharmacists and patients are appearing to improve the effectiveness of intervention programs.
• Delays in applying evidence-based treatment to patients, in particular in those with diabetes, contributed to $40 billion in annual avoidable costs. Expanding insurance coverage of appropriate screening and diagnostic testing for at-risk patients would bring this number down.
• The misuse of antibiotics contributed to antimicrobial resistance and an estimated $34 billion each year in avoidable inpatient care costs. An additional $1 billion is spent each year on about 31 million inappropriate antibiotic prescriptions, typically for viral infections.

The full study is available here.