Walgreens research: 90 day at retail generates cost savings and does not increase wastage

DEERFIELD, Ill. — A new Walgreens study examining the impact of 90-day medication refills at community pharmacies compared to 30-day refills for Medicaid patients found that across four therapeutic categories, patients with 90-day refills had greater medication adherence and greater persistency, nominal wastage and more cost savings. The study, titled "Medication Days’ Supply, Adherence, Wastage and Cost Among Chronic Patients in Medicaid," was published in Medicare & Medicaid Research Review and released Wednesday.

“Our 90-day refill program at our community pharmacies is an innovative healthcare solution that can help lower costs and improve patient outcomes, and another way in which Walgreens is advancing community pharmacy to help people get, stay and live well,” stated Jeffrey Kang, Walgreens SVP pharmacy, health and wellness services and solutions. “At the time of our study, only 13 states gave Medicaid patients the option to receive a 90-day medication supply. However, with the growing popularity and adoption of 90-day refills at community pharmacies, more and more Medicaid patients have an opportunity to benefit from face-to-face pharmacist interaction and the personalized care our pharmacists provide. Both patients and the healthcare system could benefit from reexamination of these broad state dispensing limitations.”

Compared to 30-day refills, patients with 90-day refills at community pharmacies had 20% higher adherence levels and 23% higher persistency rates. A projected savings of $13.95 per patient per year was tabulated, not including wastage costs, and adjusting for the effects of age, gender and comorbidity. 

The study’s release comes as states throughout the U.S. have aimed to contain Medicaid pharmacy costs by placing dispensing limits on medication days’ supply (most have a limit of 34 days), in an effort to limit medication wastage. The results demonstrate that wastage can be nominal across the 30-day and 90-day channels, and that three-month fills at community pharmacies have the potential to significantly improve outcomes and lower costs among Medicaid patients. Many of these patients include those with chronic conditions who often face major socioeconomic challenges affecting their ability to remain adherent to medication therapies. Notably, almost half (45%) of Medicaid beneficiaries have three or more chronic illnesses, and this population accounts for 75% of total Medicare costs, Walgreens reported. 

For the study, 52,898 patients prescribed to statin, antihypertensive, selective serotonin reuptake inhibitor or oral hypoglycemic medications were identified using California Medicaid claims from the Walgreens pharmacy chain in January 2010. Adherence is a measurement of how often patients take their medications as prescribed, and persistency is the length of time patients continue taking their medications. Medication wastage is defined as a switch of drug or drug strength within the same therapeutic class that occurred before the expected refill date.