Medication nonadherence—when a patient’s use of prescribed pharmaceuticals for a given condition does not meet established guidelines or provider recommendations—undermines the effectiveness of treatments with known clinical value. Recent efforts to improve adherence have shown promise, but the implications for how improved adherence will impact patients’ lost work time is not well known.

To help employers understand the business's value of medication adherence, IBI reviewed the literature linking medication adherence to productivity outcomes for different diseases, medications and types of lost work time. The review looked at thirteen peer-reviewed articles focused on twelve conditions, with a focus on incidental sick-day absences (absenteeism) and disability leaves from work.

While the studies provide mixed evidence that adherence-related improvements in health can reduce illness-related lost productivity in the short term, the most consistent evidence found a relationship between adherence and improved short-term disability (STD) outcomes—particularly among patients with diabetes.

Overall, the review suggests that employers could reduce costly productivity losses by increasing rates of adherence among employees with certain chronic conditions. Taken alongside findings from other research showing medication adherence reduces hospitalizations, emergency department visits, and provider office visits, the savings could be substantial.

Study Highlights

  • Significant and non-significant reductions in lost work time among adherent employees
  • Some significant reductions in STD lost work time for medication adherence among employees with diabetes, asthma/COPD, hypertension, rheumatoid arthritis, high cholesterol, and multiple sclerosis
  • Some significant reductions in sick-day absences were found for studies of diabetes, depression, hypertension, high cholesterol, coronary artery disease, and multiple sclerosis
  • Across four analyses, employees who had antidiabetic medications on hand at least 80% of the time experienced between 2.8 and 9.0 fewer STD days per year than employees who possessed medication less often.
  • Assuming average compensation costs in the United States, the annual productivity savings to employers is estimated at $794 per adherent employee with diabetes.
  • 10% increase in medication adherence among 1,000 employees with diabetes could reduce lost productivity and health care utilization costs by about $370,000.

Author Details

Brian Gifford, Ph.D. – Director, Research and Analytics, Integrated Benefits Institute
Peter Geppert – Graduate Research Associate, University of Michigan Center for Value-Based Insurance Design
Ryan Zayance – Graduate Research Associate, University of Michigan Center for Value-Based Insurance Design
Rico Lin – Data Analyst, Integrated Benefits Institute

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