It is well documented that patients’ failure to take prescribed medicines as directed costs a great deal. According to the New England Healthcare Institute, non-adherence amounts to $290 billion annually in unnecessary health care spending in the United States. Non-adherence can accelerate disease progression, lead to unnecessary disease complications, reduce patients’ functional abilities, lower quality of life, and even lead to death.
Despite this prime target for significant health care savings, the Obama administration’s most recent budget has no explicit agenda in this field, instead proposing additional rebates from pharmaceutical companies for drugs provided to low-income beneficiaries in Medicare Part D. As I wrote in April:
Drug rebates have been shown to operate just like taxes, and drug companies will respond to rebates as they would to a tax—by shifting costs to others to the extent possible. As drug costs may be one reason for patients to avoid taking their medicines, this shift could have the perverse effect of actually worsening adherence.
The rebate proposal for Part D comes after the increased Medicaid rebates and the new excise tax on brand drugs in the Affordable Care Act. In short, the Obama administration is pursuing a detrimental budget policy change — a hidden tax on pharmaceuticals — while ignoring a bigger policy matter that has even larger budget implications: improved medication adherence.
But don’t worry — here comes the FDA to the rescue. The agency recently announced a funding opportunity to address medication non-adherence and noted, “Nearly three out of four Americans report that they do not take their medication as directed. One in three people never fill their prescriptions.” Clearly a serious problem.
The FDA’s strategy? A two-year grant totaling $200,000 available only to one organization, the left-leaning National Consumers League (NCL). How should the money be spent? According to the FDA’s announcement:
The following are some specific objectives that FDA believes can further enhance the [NCL’s] “Script Your Future” campaign: (1) Addition of patient and family caregiver testimonials to the campaign Web site; (2) creation of a custom “I Will” tab on the “Script Your Future” Facebook page; (3) translation of the radio public service announcement from English to Spanish; (4) development of “Script Your Future-in-A-Box,” a turnkey package incorporating press background materials and other elements; and (5) organization of a public event in fall 2013 and a study to measure the reach of events, media, and partner engagement.
In other words, the FDA has planned a $200,000 rifle shot to one entity to enhance a social media campaign to tackle a $290 billion problem while elsewhere in the Department of Health and Human Services efforts continue to squeeze drug manufacturers with an additional de facto tax.