OBJECTIVES: Improving medication adherence has been established as a public health priority and could reduce the economic burden of several diseases. Technologies that assist patients with organizing and administering their medications have the potential to improve medication adherence. This analysis aims to evaluate the potential economic impact compliance packaging can have on medication nonadherence.

METHODS: A targeted review of articles published between 2005-2017 was undertaken in order to identify relevant articles on the potential economic impact of compliance packaging on medication adherence. Google scholar, PubMed, and grey literature were searched. Varying combinations of key words were used: Medication Adherence, Compliance, Cost of Illness, Health Care Costs, Economic Burden. Data extraction and analysis was then conducted to estimate the potential economic impact of compliance packaging on medication nonadherence. Costs were adjusted to 2017 US dollar values.

RESULTS : – Forty nine relevant articles were included in the analysis. Of the included literature: 24 papers (49%) provided reasons on why medication nonadherence occurs; 28 papers (57%) estimated the economic and clinical burden of nonadherence; 16 papers (33%) estimated improvements resulting from compliance packaging. Estimates of the economic burden range from $128-$371 billion in preventable costs. Additionally, estimates suggest that 30-50% of patients do not realize the clinical benefits of their therapy due to nonadherence. Ten studies were used to estimate the potential benefits of compliance packaging on medication nonadherence. Our stepwise calculations estimate that compliance packaging could have an economic impact of $7-20 billion.

CONCLUSIONS: Medication nonadherence is a significant clinical and economic burden that affects many parts of the US healthcare system. Patients who are non-adherent have higher acute care costs, higher outpatient costs, higher drug costs, and higher total healthcare costs. This literature review and economic analysis highlights compliance packaging as a potential opportunity to reduce healthcare expenditure for patients, payers, and healthcare systems.