Good Medicine: how to improve medication adherence and your bottom line


Ron Clerico, RPh

Vice President of Marketing, Major Pharmaceuticals

Each year, Cardinal Health asks the more than 8,000 independent pharmacies that it serves to share their best, most innovative practices in retail pharmacy.

Then a team of our own retail pharmacy experts selects the best of those nominations to be part of the annual Cardinal Health Retail Pharmacy Best Practice Guide. This annual guide helps independent pharmacies thrive in a competitive, ever-changing healthcare environment. The 2014 guide illustrates how independents can tap their unique advantages to “lead change” on the business, clinical and retail sides of pharmacy. In this special series, we'll share those best practices with our readers.

In 2009, pharmacist Mike Wilhoit, owner of a four-store family business called Mac's Pharmacy in Knoxville, Tenn., saw a big patient need. Wilhoit knew that about 50 percent of all medications are not continued as prescribed and that non-adherence not only causes 30-50 percent of treatment failures in the United States, annually, but it also causes an estimated 125,000 deaths each year. 

Mac's Pharmacy wanted to take the guesswork out of prescription drug adherence for its patients – particularly for its elderly patients, and for those who were being treated at home for chronic conditions. So Wilhoit implemented a medication synchronization solution that achieved two important objectives. First, it made it easier for patients to adhere to their medications, and second, it helped drive prescription revenue by increasing prescription refill rates. The program was so successful that it earned Mac's Pharmacy the top spot in the 2014 Cardinal Health Retail Pharmacy Best Practice Competition, in the “Retail Advantage” category. Here's how they did it.

Take charge of medication management

Mac's Pharmacy used MediSync, a medication management service that enables the pharmacy to take full control of a patient's medication management by handling refills, prior authorizations and medication changes. Each patient is assigned a Mac's Pharmacy MediSync™ coordinator who calls each month for pill counts to check adherence and to go over all of the patient's medication needs.

Participants in this program get their maintenance medications filled on the same day each month. The routine is convenient for patients and maximizes efficiency at the pharmacy.

We've changed behavior through our packaging,” said Wilhoit. “We knew there had to be a better way of packaging drugs than traditional Rx bottles. For an additional small monthly fee, through our MediSync PLUS™ program, we package patient medications through Dispill®, a multi-dose packaging solution. Dispill organizes up to a month's worth of medicine into a single package. Color codes simplify the schedule and our Mac's Pharmacy MediSync™ Coordinator

takes the time to help patients understand how to use this packaging to achieve maximum benefits. Using Dispill helps patients know what to take and when. We've actually received written thank you notes from family members. One woman was near tears when thanking us for helping her mother.”

Find a time-efficient packaging tool

“We started with a packaging system that was labor intensive and not as user-friendly. Then, we found the Dispill® system. It's fantastic! Our staff required almost no training other than watching a five-minute video,” said Wilhoit. “It lowered the cost of providing the service to our patients dramatically and allowed us to do compliance packaging at each of our stores.”

Remember: the proof is in the adherence

A pharmacy resident designed a study to measure the adherence level of Mac Pharmacy patients who participated in the program. He measured the proportion of days covered, based on a 30-day medication cycle. In the study of 51 patients, those enrolled for 90 days or more had a 91.9 percent adherence rate in MediSync and 96.7 percent in MediSync Plus, compared to clinical trials showing typical adherence rates of 43–78 percent for chronic conditions.

What's good for patients can also be good for business

By significantly driving medication compliance, Mac's Pharmacy was also able to improve refill rates – by an average of six more refills in a calendar year, per patient. The program also has helped Mac's Pharmacy partner with home health care providers, assisted living facilities and nursing homes.

"When we started, we didn't have any long-term care business. Now, we have a separate pharmacy dedicated to that business, serving 10 communities and growing," said Wilhoit.

Marketing matters

Mac's Pharmacy has marketed this adherence program through flyers, brochures and sample packs provided during counseling sessions. Wilhoit also hired a marketing representative to explain the program to physicians, nursing agencies and other healthcare providers.

"Word of mouth is what turned really the corner for us. Providers began reaching out to us to enroll patients. Also, the first month of MediSync Plus™ is free so people can see its benefits. Customers are amazed at what they get for the $10 cost of the service."