Prescription Abandonment Numbers on the Rise

The number of patients abandoning their prescription drug treatments spiked 34 percent according to a Wolters Kluwer report released to Pharm Exec on Tuesday.

Abandonment is measured when a pharmacist submits a claim to the insurer, the insurer pays the amount that it’s supposed to cover, but the patient never picks up the drug. As of the fourth quarter of 2008, the abandonment rate for prescription drugs was 6.77 percent, while the rate for generic drugs was 4.14 percent.

“It’s usually financial implications, particularly around copays for out of pocket costs, that drive the abandonment rate more than anything else,” said Dea Belazi, practice leader, managed markets at Wolters Kluwer.

Copay rate plays a major role in the decision to abandon a drug, according to the report. Branded drugs that cost more than $30 are twice as likely to be ditched at the pharmacy, while drugs that cost less than $10 are only abandoned about 5 percent of the time.

To combat abandonment, drug companies have begun working with the insurance provider to negotiate a lower out-of-pocket cost for the patient. For example, if a drug is in a higher tier, the pharma company will try to get the drug on a lower tier. Coupon distribution and loyalty cards are also becoming more commonplace to help offset some of the costs.

Belazi told Pharm Exec that the rate abandonment also differs significantly between therapeutic categories. Biotech, for instance, has much higher copay rates, and in turn has a much higher abandonment rate.

“The trend from 2006 has been edging higher because of increasing copays and economic conditions over the past 12 months,” Belazi said.

Abandonment should also not be confused with compliance problems, which costs the drug industries billions of dollars each year. “Compliance is overall a larger issue that would include abandonment as a potential reason, but also includes side effects, cost, and forgetfulness,” Belazi said.

Additionally, the number of denied prescriptions has increased 26 percent since 2006. Nearly 11 percent of branded medications were denied by health plans in the final quarter of 2008, up from an average of 8.6 percent in early 2006.