ISSUE: There are potentially two payers for medication adherence enhancing interventions, the payer and the pharmaceutical manufacturer. While the improved health outcome is of utmost interest to the payer, increased adherence is of significance to the pharmaceutical manufacturer. Though both payer and manufacturer have a stake in improved medication adherence, it is yet unclear who would or should be responsible for paying MAEIs.

OVERVIEW: The responsibility of medication adherence falls on patients (Brown, 2011) with the providers often being held accountable for lack of adherence (Cutler, 2010). Research has shown that MAEIs can improve adherence (DeFulio, 2012) and both Defulio and Bosworth (2011) call for research on the long-term effectiveness of the patient pay-for-performance model.

Embedded in this is the need to determine who should pay for MAEIs and whether they should be incentivized. Kardas (2022) suggests that it may be reasonable for healthcare systems to “assign special funds” to assist in improving adherence. Others suggest that the pharmaceutical manufacturers should pay for these interventions (Healthprize, 2022). The other question is, what is being paid for? The DeFulio (2012) review suggests MAEIs are worthwhile, but Barankay (2020) indicates that while adherence improves, clinical outcomes may not.

This panel will examine the question of what MAEIs should be paid for and who should be paying for them from three different perspectives: the payer, the provider, and the manufacturer. The payer will discuss why they should/should not be responsible for paying for MAEIs as well as what they would be paying for. Similarly, the manufacturer discuss what they would consider a reasonable outcome to pay for, should they be paying for it. Finally, the provider will offer their insights into how either payment model would impact their practice and how effective they think each approach to adherence would be for their patients.