According to the Centers for Disease Control and Prevention, about half of all Americans have been prescribed a medication of some kind, and at least 25 percent have been prescribed at least three – the operative word here being “prescribed,”as opposed to “use.”
Between 20 and 30 percent of those prescriptions are never filled, and half of those taken for chronic conditions are not used as prescribed. That has enormous financial and safety implications. The estimates are that each year nonadherence leads to an additional $300 billion in healthcare costs, and results in over 100,000 deaths.
Cost is, of course, a major reason for nonadherence. One study showed that over one in four Medicare beneficiaries and roughly one in 20 privately insured adults devote over one percent of their income to medications, and another study showed that in 2018 and 2019 over 13 million Americans declined to fill a prescription, or delayed doing so, because of cost.
Reducing such costs is obviously a sizable concern, and one with which government officials continue to grapple. For the purposes of this piece, let us focus on removing the other barriers to medication adherence, of which there are many.
The American Medical Association lists such matters as concern over side effects, worries over becoming too dependent on any given medication and a lack of symptoms (i.e., the patient didn’t believe there was a need to continue taking the drug) among the reasons for non-adherence, as well as a misunderstanding of just why the medication was prescribed and mistrust of why the doctor was prescribing it. Over half the time, the AMA asserts, improved communications with a clinician can help alleviate these issues.
Certainly, however, there are technological methods that would go a long way toward ensuring adherence, including solutions that make use of blockchain, the secure, immutable online ledger most often associated with cryptocurrencies like Bitcoin. Consider, for example, ScriptDrop, a company that since 2016 has partnered with healthcare organizations in all 50 states to avail patients of medications.
Patients’ information is stored in blockchain, and ScriptDrop, besides delivering the drugs to their door, sends multi-channel reminders to them about taking them as prescribed. Patients then self-report adherence, and earn cryptocurrency rewards that can be used to help defray the costs of future medication purchases.
To date, ScriptDrop is the only IT company that makes prescription access possible in every state, but one survey concluded that over 70 percent of patients, prescribers and pharmacists look favorably upon blockchain-based operations. Moreover, it is expected that the medication adherence market, which consists of software systems and hardware applications, will continue to grow. It stood at $2.8 billion in 2021 and is expected to be valued at $3.2 billion by the end of 2022 and $4.8 billion by 2026.
Acceptance of this approach is further reflected in the fact that a blockchain-based medical-record platform, My PCR, has found its footing in Great Britain. According to the website Guardtime.com, it is capable of providing information and medication-adherence support to as many as 30 million people.
There is, in short, a groundswell in this space, and one that figures to continue, given the obvious issues that can result from nonadherence. Going forward, other enterprises are likely to make inroads, as they capitalize on the opportunity that blockchain, versatile as it is, can present.