Medication adherence and productivity: summary of research findings

Approximately half of adult Canadians have at least one chronic health condition, and medication is often part of treatment. Yet medication adherence levels can be low—for some chronic conditions, such as depression, the rate of adherence can be less than 50%. Medication adherence is essential for positive health outcomes—how does that translate in terms of productivity in the workplace? A closer look at 40 research studies shows that the impact can be significant.

The literature review, funded by brand-name pharmaceutical companies and commissioned by a working group comprised of Innovative Medicines Canada (representing brand-name pharmaceutical companies), Canadian insurers and group benefits consultants, found that medication non-adherence overall results in two to 10 missed work days per employee per year, and $1,000 to $5,000 in salary losses per employee per year.

The analysis drilled down further to illustrate how medication adherence affects productivity for employees with hypertension, depression and diabetes—which are typically at the top of plan sponsors’ drug-plan spend. It found that even average adherence levels, which are less than optimal, generate at least some positive outcomes versus not taking any medication at all, while optimal adherence levels, as expected, would significantly improve productivity and generate significant savings for employers.

The analysis used the following average adherence rates, based on the clinical studies: 63% for hypertension medications, 61% for diabetes medications, and just 43% for depression medications. In other words, a person with depression took their medication as prescribed 43% of the time. Even at these sub-optimal levels, the medications generated the following average savings for employers:

• 16.1 days and $3,306 among employees with diabetes;
• 9.1 days and $1,870 among employees with depression; and
• 3.5 days and $714 among employees with hypertension.

When adherence levels are increased to 80%, which is recommended to achieve optimal outcomes, employers stand to gain up to an additional $2,200 per employee in net savings (factoring in the additional cost for taking medications more regularly). The return on investment is especially good for employees taking medications for diabetes or depression. For example, an additional $264 per year for drugs to treat depression, to reflect an adherence rate of 80%, would generate an additional $2,216 in savings for the employer.

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