Non-adherence can negatively impact medication treatment strategies, particularly among oncology patients, driving up treatment costs while potentially worsening clinical outcomes.
Although oral oncolytics offer convenience, they arguably require greater patient engagement in remembering to take their treatment, often resulting in lower adherence compared to infused therapies. Chronic lymphocytic leukaemia (CLL) is increasingly managed with long-duration, targeted oral treatments. Yet, non-adherence to these oral agents remains high, with rates cited between 37% and 59%.
Various interventions, including medication compliance packaging, have improved adherence in other chronic diseases. Although existing research suggests that blister-packaging can enhance medication adherence, and increased adherence often correlates with better outcomes and lower expenses, no studies currently connect these factors in oncology.
A team of economic outcomes researchers have therefore recently estimated the potential cost-saving effect of blister-packaging oral CLL therapies for this patient population.
Improving adherence to oral oncolytics
An economic model was generated, focusing on an estimated 20,700 newly diagnosed CLL patients initiating treatment in a single year. It drew on previously published data for medication adherence and assumed a 13% boost in adherence from blister-packaging based on prior research in chronic disease. The model captured total healthcare costs, covering both medical and pharmacy expenditures.
Results demonstrated that baseline adherence (62.7%) rose to 67.5% after blister-packaging was introduced in the model. Fiscal impacts of increased adherence meant that pharmacy costs rose by $61,589,670, translating to an extra $247.95 per patient each month. However, medical expenses fell by $82,285,847, or $331.26 per patient monthly. Altogether, this yielded a total net healthcare savings of $20,696,177, equivalent to $83.32 lower costs per patient per month.
Assessing clinical outcomes required
Recognising limitations on the generalisability of these findings, the authors acknowledged that ‘due to variations in treatment effectiveness and disease severity, it remains challenging to determine how these results from CLL would translate to other cancer types.’
The authors also point out that consideration should be given to additional pharmacy-related safety measures potentially required in repackaging these medicines.
Commenting further on the practical application of this study’s results, the researchers noted that their work is ‘hypothesis generating’ and that future investigations should evaluate clinical outcomes like survival, quality of life and patient satisfaction as well as adherence.
Reference
Borrelli EP et al. Enhancing medication adherence with blister-packed oral oncolytics: A case example in chronic lymphocytic leukemia. Journal of Oncology Pharmacy Practice. 2025;0(0).
