When the pharmacist reviews her list of patients and sees that a 75-year-old man hasn’t picked up his prescription refill, she wonders if it’s because of one of several common situations. Maybe he’s been skipping doses, taking smaller doses than prescribed, or even stopped the medication altogether.
If these changes to his medication regimen were not intentional steps in his care plan, they can be detrimental to his health. Medications do not work as well as they should when people don’t take them as their physician prescribed. And that makes poor health outcomes such as trips to the emergency room and hospitalizations more likely.
So, rather than shrugging her shoulders and moving on to the next task, the pharmacist calls the patient to figure out why he hasn’t picked up his pills and to see if they can find a solution to help him take his medication in the prescribed dose and frequency.
This scene played out again and again in pharmacies across the country last year thanks to UnitedHealthcare’s TIP® Challenge. Participating pharmacies engaged in friendly competition to improve medication adherence rates among people enrolled in UnitedHealthcare’s Medicare Advantage-Part D plans who are taking medications for diabetes, high blood pressure and high cholesterol.
The six winners in the 2017 TIP® Challenge were Publix and Albertsons/Safeway in the large pharmacy category (1,000+ locations), Meijer and Ahold USA in the medium-sized pharmacy category (200-999 locations), and Discount Drug Mart and Brookshire Grocery Company in the regional retail pharmacy category (fewer than 200 locations).
Pharmacists in the challenge were tasked with helping older adults overcome some of the most common obstacles that prevent them from taking their medicine as prescribed. Memory issues can make it difficult for patients to remember to take their medicine—or to pick up a refill. People with a complicated medication schedule may simply get confused about what medication they are supposed to take, how much and when. For others, the cost of medication might be a financial hardship, leading them to try to “stretch” their medicine by taking it less frequently than prescribed.
After speaking with their customers to identify the root cause of their medication challenges, the pharmacists then set out to find solutions. A pillbox with separate compartments kept in a prominent place can be helpful for people with memory issues, and pharmacists may be able to work with physicians to find lower-cost alternatives for those who can’t afford a particular prescription. In some cases, pharmacists informed customers about the option to receive a 90-day supply of their medications, which can help save money and also be beneficial for people who have difficulty getting to the pharmacy on a regular basis.
UnitedHealthcare enlisted OutcomesMTM®, a Cardinal Health company, to administer the competition through its Targeted Intervention Program (TIP®). OutcomesMTM connects pharmacies across the country with opportunities to provide medication therapy management services to their eligible patients.
“Pharmacists have an incredibly important role to play in making sure seniors and other Medicare beneficiaries are getting the best results from their medications by taking them safely and effectively,” said Brian Thompson, CEO of UnitedHealthcare Medicare & Retirement. “We’re grateful to the winners of this year’s TIP Challenge and all of the participating pharmacies for helping to improve our members’ health and well-being.”
UnitedHealthcare donated $15,000 to the American Diabetes Association (ADA) on behalf of each winner, for a total of $90,000. Since establishing the TIP Challenge in 2015, UnitedHealthcare has donated approximately $270,000 to charitable causes in recognition of the winning pharmacies.
UnitedHealthcare selected the ADA as the beneficiary of the donation because of the heavy toll that diabetes takes on older adults. Approximately 25 percent of people enrolled in a UnitedHealthcare Medicare Advantage plan have the disease, and many of them have complicated medication regimens that can be difficult to follow. For example, it’s not uncommon for people with diabetes to be prescribed glucose-lowering medicine in addition to medicine to lower cholesterol and blood pressure.i
Medication adherence problems certainly aren’t limited to people with diabetes, however. Nearly three in four adults fail to take medications as prescribed, according to the Pharmaceutical Research and Manufacturers of America.ii For older adults, sticking to medication schedules is particularly important: Nearly 90 percent of adults over 65 take at least one prescription medication, and nearly 40 percent take five or more.iii
“Thank you to UnitedHealthcare for their commitment to helping to meet the unique needs of people with diabetes and for their generous donation to ADA,” said William T. Cefalu, MD, chief scientific, medical and mission officer of the American Diabetes Association. “Medication management can be overwhelming for the more than 30 million Americans living with diabetes. The TIP Challenge underscores the important role pharmacists play in supporting older adults with diabetes and helping to encourage medication adherence, leading to improved quality of life and health outcomes.”
Plans are insured through UnitedHealthcare Insurance Company or one of its affiliated companies. For Medicare Advantage and Prescription Drug Plans: A Medicare Advantage organization with a Medicare contract and a Medicare-approved Part D sponsor. Enrollment in these plans depends on the plan’s contract renewal with Medicare.
i Blackburn, D.F., Swidrovich, J., Lemstra, M. (2013). Non-adherence in type 2 diabetes: practical considerations for interpreting the literature. Journal of Patient Preference and Adherence. 7:183-189. doi: 10.2147/PPA.S30613
ii Improving Prescription Medicine Adherence is Key to Better Health Care, PhRMA, January 2011 http://phrma.org/sites/default/files/pdf/PhRMA_Improving%20Medication%20Adherence_Issue%20Brief.pdf
iii Health, United States, 2015, with Special Feature on Racial and Ethnic Disparities. Table 79: “Prescription drug use in the past 30 days by sex, race and Hispanic origin, and age: United States, selected years 1988-1994 through 2009-2012.” U.S. Centers for Disease Control and Prevention and the National Center for Health Statistics https://www.cdc.gov/nchs/data/hus/hus15.pdf#079
All other statistics in this release can be attributed to UnitedHealthcare Internal Data, 2017.