OBJECTIVES : Medication synchronization is a promising intervention to improve medication adherence and health outcomes, especially for patients with multiple chronic conditions and complex medication regimens. This study evaluated its impact on the adherence for three therapeutic classes - diabetes, hypertension and hyperlipidemia, as well as the annual expenditures for subjects covered by commercial health plans.

METHODS : This retrospective, propensity matched (by age and gender), study used 2015-2017 IBM MarketScan® Databases to identify individuals with four chronic medications filled between January-June 2015 with at least one fill in three therapeutic classes. The test (synchronized) group filled on the same date, and the propensity score matched control (non-synchronized) group filled on more than one date within the same period. Adherence rates (proportion of days covered ≥ 0.80 as defined by CMS) in three therapeutic classes and outpatient medical and pharmacy cost for all reasons across three years were computed in test and control groups.

RESULTS : Test and control group each contains 37,623 patients with average age of 54.3 and 58.5% of male after matching. In 2015, average adherence rates were modestly higher (p<0.0001) in the test group than that of the control group: 83.4% vs. 82.2% for diabetes, 85.8% vs. 84.4% for hypertension, and 83.4% vs. 80.3% for hyperlipidemia. The higher adherence seen in the test group continued into 2016. Outpatient medical cost decreased substantially (p<0.0001) in 2015 ($4,330 vs. $5,783), 2016 ($5,317 vs. $6,491) and 2017 ($5,624 vs. $6,862). Annual pharmacy cost dropped in the test group as well.

CONCLUSIONS : Chronic medication self-synchronization in commercial populations are associated with the greater medication adherences for three major therapeutic classes, and lower trends in healthcare expenditures. This study used real-world evidence to reveal a possible intervention strategy towards the economic outcome of patients with multiple medications for their chronic conditions.