Background: Healthcare utilization and cost impacts, of medication adherence above or below the 80% threshold remains unclear for cardiometabolic medications.Objective: To evaluate the differences in cardiovascular (CV)-related emergency department (ED) visits and total cost-of-care associated with changes in medication adherence around the 80% threshold.Method: Retrospective observational analysis of claims spanning from Jan 1, 2021, to June 30, 2023.Patients aged 50-80 years with a history of cardiovascular disease (CVD) and specific cardiometabolic medications were followed for 12 months, and pre-post index-fill outcomes compared.Patients were categorized into pre-and post-index groups: 3 preindex groups (Pre1-moderate, Pre2-high, Pre3-very-high) based on their pre-index 12month adherence PDC and 4 post-index groups based on post-index PDC (Post0-low, Post1-moderate, Post2-high, Post3-very-high), for 4 medication classes (Antidiabetics, direct oral coagulantsDOACs, antiplatelets, and anti-heart-failure meds HF).Group definitions: Post0-low (PDC=90).Outcomes included per-member-per-year PMPY total cost-of-care, and cardiovascular-related ED visits.Results: There were 55, 934(antidiabetics), 46,290 (DOACs), 65,659 (antiplatelets), and 49, 670 (HF) patients in the final sample.Most of the patients in the HF (46-53%) and DOAC (51-57%) groups were in the 70+ age group.Among patients in the antidiabetic (45-47%) and antiplatelet (39-43%) groups, the majority were in the 60-69 age group.In general, J o u r n a l P r e -p r o o f 1 patients who moved from a lower adherence group to a higher adherence group had lower total cost-of-care in almost all groups and medication classes.Moving from PDC >= 90 to PDC <90%, total cost-of-care was higher in all 4 medication classes. Conclusion:Improving adherence to and beyond the traditional 80% target was associated with lower total cost-of-care.
Peasah et al. (Sun,) studied this question.