(163) Characteristics associated with being adherent in patients experiencing late refills before and after the implementation of a refill reminder program

Background: : Pharmacy benefit managers (PBMs) are tasked with improving member engagement and promoting medication adherence. Refill reminder programs can increase members’ likelihood of refilling their medications and maintaining their health.

Objective: : The objective of this study was to evaluate the association of various plan member characteristics and the outcome of having a proportion of days covered (PDC) greater than 80% (adherent) for three medication classes: diabetes (DM), hypertension (HTN), and statins in four Medicare Part D health plans with populations of less than 3,000.

Methods: : Two cohorts for calendar years 2023 and 2024 were identified. Members had to be eligible in both years, filled refill reminder target drugs (once in the first and last halves of the calendar year), and have one late claim within a target drug group in the first six months of the year. Descriptive statistics and general linear regression for a binary outcome was used to model the odds of being adherent with member characteristics (year, age at study midpoint, sex, month of first late refill, drug class, use of multiple drug classes, use of 90-day supplies, total annual late refills, and total annual late refills refilled).

Results: : A total of 3,006 members were included in the study. Total nonadherent members were 233 (14.6%) in 2023 and 189 in 2024 (13.4%) (p-value 0.3103). Characteristics with increased odds of being adherent included having the first late refill in February or March (OR 5.89, p-value 0.0012; OR 2.14, p-value 0.0093) and being in year 2024 and in the DM drug group (OR 1.84, p-value 0.0437). Being female and in the DM drug group (OR 0.51, p-value 0.0337) and being in the DM drug group and in more than one drug group (OR 0.23, p-value 0.0305) had decreased odds of adherence. Having an increasing number of late claims and in the DM drug group (1.36, p-value 0.0032) or using 90-day supplies (2.22, p-value 0.0009) had increased odds of being adherent, while having an increasing number of late claims and an increasing number of late claims refilled had decreased odds of being adherent (0.9, p-value < 0.0001).

Conclusions: : Being adherent involves complicated factors related to the individual’s unique characteristics. In this study refilling late medications, being on multiple drug groups, and using 90-day supplies were associated with increased odds of being adherent. Being in the 2024 cohort and being on a DM medication also had increased odds of adherence. Further research is needed to explore the effects of the refill reminder program on adherence in similar populations.

Sponsorship:: MedImpact Healthcare Systems, Inc.