Health plans and health systems play a critical role in addressing health disparities and advancing health equity, but a growing body of research suggests that the lack of reliable and actionable data is a major barrier to their success.
According to a study by Deloitte, health disparities and inequities cost the U.S. health system more than $320 billion per year, and without a solution, that number could balloon to more than $1 trillion by 2040.1
The Centers for Disease Control and Prevention (CDC) defines health disparities as preventable differences in the burden of disease, injury, violence, or in opportunities to achieve optimal health experienced by socially disadvantaged racial, ethnic, and other population groups and communities. 2
In their recently released framework for health equity, The Centers for Medicare & Medicaid (CMS) states that their number one priority is to expand the collection, reporting, and analysis of standardized data.3
As the healthcare industry works together to find and expand adequate sources of data, collecting and analyzing pharmacy data can play a key role in identifying health disparities and improving outcomes for all.
Identify Health Disparities with Pharmacy Data
The first step in addressing health disparities is identifying them, and pharmacy data can provide health plans with valuable insights into patients’ medication history, including adherence rates, utilization patterns, and medication-related outcomes. By analyzing pharmacy data, health plans can identify disparities in these areas among different patient populations.
For example, pharmacy data may show that certain populations have lower rates of medication adherence, which can contribute to worse health outcomes. Or, it may show that a certain population has a high prevalence of a particular condition, such as diabetes. Healthcare providers can use this information to develop targeted interventions, such as medication therapy management services, that help improve health outcomes for that population.
Once health disparities have been identified using pharmacy data, healthcare professionals can develop targeted interventions to address them.
Improve Medication Adherence
Medication non-adherence is a significant issue in healthcare, and while it can be a challenge across all populations, certain populations may face additional barriers.
According to Gallup, 18 million people in the U.S. could not afford to pay for at least one of their prescribed medications and more than 10% of Americans reported skipping doses to save money.4 Pharmacy data can help identify patients who are at risk of medication insecurity, such as those who have difficulty affording their medication, have transportation or mobility issues, or have a history of non-adherence.
Once the at-risk patients have been identified that same data can be used to improve medication access by providing information on drug formularies, co-pay assistance programs, and other resources that can help patients afford their medication.
Health plans and providers can also utilize pharmacy data to develop and tailor interventions to the needs and preferences of specific populations to ensure all patients have access to safe, effective medication regimens. This can involve reviewing a patient’s regimen, identifying potential drug interactions, and providing education to improve medication adherence and reduce medication-related problems.
Prevent Adverse Drug Events
Adverse drug events (ADEs), which occur when patients experience negative side effects or complications from medication use, are a costly issue in healthcare and can have a significant impact on patient health outcomes. In the U.S., ADEs lead to more deaths than traffic accidents, auto immune disorders, and breast cancer, and are responsible for up to $180 billion in healthcare expenditures each year.5,6
Health disparities can play a role in the occurrence of ADEs, as certain patient populations may be more susceptible to adverse effects due to factors such as medication access, health literacy, and social determinants of health. And recent research shows that women may be 1.5 to 1.7 times more likely than men to experience ADEs.7
Pharmacy data can be used to track ADEs, identify patterns of medication-related harm, and inform interventions to prevent them in the future. Clinical decision support tools leverage rich pharmacy data that alerts providers of potential drug interactions, allergies, and other contraindications, helping them make informed decisions about medication management.
Medication reconciliation strategies utilize pharmacy data to reconcile a patient’s medication list across different healthcare settings, such as during transitions of care or when a patient sees multiple providers. By comparing medication lists and identifying discrepancies, pharmacists can help prevent ADEs that may result from duplicate therapy, drug-drug interactions, or other medication-related problems.
Improve Health Outcomes
Pharmacy data can provide valuable insights into medication use patterns and patient behavior. And as healthcare continues to shift towards value-based care, the importance of this data will only continue to grow. Health plans and at-risk providers can leverage pharmacy data as a critical tool to address health disparities, promote medication adherence, and advance health equity, improving outcomes for all patients.
- Bhatt J, Gerhardt W, Davis A, et al. US health care can’t afford health inequities. Deloitte Insights. 22 Jun 2022;31. https://www2.deloitte.com/us/en/insights/industry/health-care/economic-cost-of-health-disparities.html.
- Centers for Disease Control and Prevention. Health Disparities. cdc.gov. 2017. https://www.cdc.gov/aging/disparities/.
- CMS Framework for Health Equity. 2023. cms.gov. https://www.cms.gov/about-cms/agency-information/omh/health-equity-programs/cms-framework-for-health-equity.
- Witters D. In U.S., an estimated 18 million can’t pay for needed drugs. Gallup. 21 Sept 2021. https://news.gallup.com/poll/354833/estimated-million-pay-needed-drugs.aspx
- Muhammad FR, Rehman A, Khan I, et al. Assessment of risk factors associated with potential drug-drug interactions among patients suffering from chronic disorders. PLoS ONE. 24 Jan 2023;18(1):e0276277. https://doi.org/10.1371/journal.pone.0276277.
- Peabody J, Acelajado MC, Robert T, et al. Drug-drug interaction assessment and identification in the primary care setting. J Clin Med Res. 9 Oct 2018: 10(11);806-814. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6188027/.
- Hendriksen LC, van der Linden PD, Lagro-Janssen ALM, et al. Sex differences associated with adverse drug reactions resulting in hospital admissions. Biology of Sex Differences. 3 May 2021;34. https://bsd.biomedcentral.com/articles/10.1186/s13293-021-00377-0#:~:text=Adverse%20drug%20events%2C%20including%20adverse,more%20likely%20to%20develop%20ADRs.