Adherence Reduces Cost in Diabetes

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Patients with diabetes and high cholesterol can save the health care system millions of dollars by properly taking their medication, according to a new study..

• The National Institute of Mental Health has estimated that schizophrenia costs the United States about $32.5 billion each year for about 2 million patients with the diagnosis

• The majority of direct health costs related to schizophrenia are attributable to hospitalizations for both initial episodes and later relapses. At least half of the relapses can be associated with a lack of compliance with drug therapy, with the remainder linked to issues of treatment efficacy.

• The review found a mean rate of relapse of 76 percent within the first two years after discontinuation of an antipsychotic treatment, even among patients whose illness was considered to be in remission. Relapse rates for patients who took maintenance medication intermittently were about twice those for patients who took medication continuously

• The review suggests an overall monthly relapse rate of approximately 11 percent for noncompliant patients, based on average follow-up periods of six months to two years. This rate is equivalent to a 75 percent annualized risk of relapse for noncompliant patients.

• This general pattern of relapse data—approximately 75 percent for poor compliance and 35 percent for good compliance.

• Poor compliance with medication treatment is likely to result in an increased frequency of relapse, more intense symptoms, and longer inpatient stays.

These studies provided resource use and unit cost data that suggest a range of estimates for relapse costs of between $10,000 and $26,000 per episode

(hospitalization represents around 85 percent to 95 percent of the relapse costs, with the remainder distributed among the costs of increased drug dosages, additional clinic follow-ups over the subsequent year, and general case management.).