Medication adherence is hard. With COVID-19, it’s more challenging than ever.

Flattening the curve is in part about reducing the burden on our healthcare system, so that our brave medical professionals can focus on treating COVID-19 patients. With this in mind, it is more important than ever for patients to prioritize medication adherence to prescribed therapies and to focus on healthy lifestyle choices. Patients managing one or more chronic conditions routinely fail to take their medications as prescribed for a variety of reasons, including logistical and financial challenges that have been compounded in the face of COVID-19, a disruptive, fast-moving public health emergency.

People everywhere are being told to shelter in place and to maximize their social distancing to help flatten the curve of the Coronavirus spread. Public transportation systems are experiencing service interruptions, local pharmacies are limiting their hours. People are scared. Should you venture out to pick up your medications or should you just stay home?  

The decision to refill your prescription is further complicated by the specter of financial hardship looming on the horizon. People everywhere are concerned about losing their jobs, lost wages, cash-flow problems, and the direct and indirect impact of the stock market’s enormous volatility during this tumultuous time. This financial uncertainty will likely only amplify financial barriers to accessing medication, especially for patients who already struggle to manage costly drug regimens consisting of multiple, specialty medications. 

Patients are likely feeling particularly overwhelmed during this fast-moving and unprecedented pandemic. How to stay adherent to your medication feels more daunting than ever. 

Key stakeholders in the pharmaceutical value chain such as pharmacies, manufacturers, health plans, and providers have come together to fight medication non adherence and to provide additional support to help patients maintain a steady supply of medications and stay healthy. Consider the following examples:

 Pharmacies

Pharmacies are doing their best to keep shelves stocked and minimize the impact of both potential interruptions in the supply chain and unexpected shortages of particular medications. Nonetheless, problems can arise. Here are some strategies to consider:

• Some pharmacies, such as CVS Health, are supporting medication-adherence objectives and the need for social distancing by waiving the fee for home delivery of prescription medications.
• Individual health plans and pharmacists are already routinely authorized to substitute costly branded medications for generic alternatives. Today, in response to the current crisis, many pharmacists are able to dispense substitute medications — alternative prescription drugs that are deemed to be clinically appropriate in the same therapeutic class. Such flexibility can help patients ensure continuity in their medication supply, even if their local pharmacy is temporarily out-of-stock, or if the medication is in a nationwide shortage because of a supply chain interruption.
• Other companies, such as Amazon’s PillPack service, allow prescription medications to be delivered to a patient’s home.

Pharmaceutical manufacturers

Widespread layoffs, lost wages as businesses everywhere have been forced to close suddenly, and the falling stock market have created a perfect storm of financial concern as this global pandemic unfolds. Those who rely on costly medications to help manage chronic health issues should investigate some options that are available to offset their out-of-pocket expenses:

• Drug-specific Patient Assistance Plans (PAPs) are offered by many pharmaceutical manufacturers (and by some disease-related charitable foundations and state governments, as well). These programs provide high-cost medications at no cost to patients who meet the program’s financial eligibility criteria or are uninsured or underinsured. The non-profit RxAssist.org provides a comprehensive directory of PAP options. This article from WebMD describes these programs and provides links to several related resources.

Health plans

Regardless of whether you receive your medications from a retail pharmacy or a mail-order pharmacy, the ability to switch from a 30-day supply to a 90-day supply is an important option to consider given that it allows you to have more medication on hand with fewer trips out of the house. Supporting this transition is one way that we at Sempre are helping members ensure an uninterrupted supply of medications in your medicine cabinet and uphold important adherence objectives.

• Some health plans, such as one of our Blues partners, have relaxed the parameters on 30-day prescriptions, allowing patients to pick up their next monthly refill sooner than was previously allowed, to afford greater flexibility during shelter-in-place mandates. While its members have long been able to order a 90-day supply through its mail-order pharmacy, our partner is now covering 90-day supplies purchased at retail pharmacies to support adherence objectives.

 Providers

This fast-moving crisis has already demonstrated the vast potential of online connectivity. As a result, greater emphasis is being placed on patients’ ability to utilize telehealth resources. These tools and support programs use video conferencing, audio, text and other forms of interactive online messaging to allow patients to seek medical advice, speak to a nurse or pharmacist, and receive other forms of clinical support remotely.

• As shelter-in-place mandates force patients to limit travel — a diverse coalition of stakeholders is helping to make online, interactive resources available at no charge to patients (this includes efforts from many pharmacies, pharmaceutical companies, private health plans and Medicare).  
• At least 18 states have enacted emergency regulations to increase the use of telehealth resources, allowing patients to access healthcare resources more easily online.
• Patients — especially those who are managing one or more chronic conditions — should take full advantage of these innovative, technology-based solutions to not only access personalized clinical support and reduce lapses in their prescription supply, but to limit their own exposure and overcrowding by keeping them out of physician offices and crowded waiting rooms.

Prioritizing medication adherence and making lifestyle choices are exceptionally important now as they will safeguard your health and prevent avoidable medical episodes at a time when the nation’s healthcare infrastructure is being pushed to its limits. Sempre Health is honored to be working alongside the other stakeholders described above to assist patients this time.