Specialty Drug Adherence Barriers
- Cost: High cost-sharing discourages refills
- Side effects: Adverse drug reactions lead to discontinuation
- Complexity: Complex administration (injections, infusions) reduces adherence
- Disease progression: Patients who feel better may stop taking medication
- Access: Difficulty obtaining refills or prior authorization delays
- Stigma: Stigma associated with certain conditions (HIV, mental health) reduces adherence
Adherence Measurement
Specialty drug adherence is measured using the Medication Possession Ratio (MPR) or Proportion of Days Covered (PDC). MPR = total days of medication supplied / total days in the measurement period. PDC = number of days covered by medication / total days in the measurement period. A PDC of 80%+ is considered adherent. Measure adherence for each specialty drug category and benchmark against industry standards.
Adherence Programs
IQ Insight
Specialty pharmacy adherence programs — proactive outreach, injection training, side effect management, and financial assistance — can improve adherence by 10–20%. Improved adherence reduces disease progression, hospitalizations, and total healthcare costs. For a specialty drug that costs $50,000/year, a 15% improvement in adherence that prevents one hospitalization ($30,000) delivers a 3:1 ROI on the adherence program.