The IMS Institute for Healthcare Informatics has identified six levers that can be applied to improve medicine used worldwide and empower public and private stakeholders to realise nearly a half-trillion dollar avoidable cost opportunity. This represents eight per cent of total annual global health expenditures. The levers are detailed in a study, advancing the responsible use of medicines: applying levers for change, released by the IMS Institute during a global summit for Ministers of Health held in Amsterdam.

The study defines responsible use of medicines as the alignment of all elements of a healthcare system – including professionals and patients – in ensuring that individuals receive the right medicines at the right time, use them appropriately, and benefit from them. Calling responsible medicine use an “urgent imperative” for the global health system, the IMS Institute study found that medicine policy is often isolated from other healthcare initiatives in the intensifying efforts to contain costs. Such an approach does not consider the significant impact that improved medicine use can have on overall health system spending.

The following levers can be applied by health system leaders to improve the use of medicines:

Increase medicine adherence by addressing patient beliefs and behaviours at the point of prescription and during medicine intake.

Ensure timely medicine use that prevents avoidable and costly consequences among patients with highly prevalent diseases that increase in severity if diagnosis and treatment are delayed.

Optimize antibiotic use to turn the tide on rising antimicrobial resistance worldwide due to the misuse and overuse of antibiotics.

Prevent medication errors throughout the medicine provision pathway, from prescription to administration.

Use low-cost and safe generic drugs where available to leverage the under-exploited opportunity in post-patent expiry markets.

Manage polypharmacy where the concurrent use of multiple medicines, particularly among the elderly, risks costly complications and adverse events.

Improvements in patient adherence make up more than half – $269 billion – of the $500 billion annual opportunity in avoidable healthcare costs. The study also focuses on two key factors critical to driving improvement across the six levers: multi-stakeholder engagement, and the power of information. Prescribers, dispensers, the pharmaceutical industry and patients can all play a role in aligning the health system to drive improvement. In addition, sufficient information exists within and across countries to set priorities, monitor progress and drive behaviour change.

“As our study makes clear, medicines – and the policies and practices that govern their use – are an essential and under-appreciated piece of the global healthcare puzzle,” said Murray Aitken, executive director, IMS Institute. “Harnessing available information to set priorities, monitor progress and support behaviour change among healthcare stakeholders – including policymakers, payers, clinicians, nurses, pharmacists and patients – is a vital first step. By framing the challenges and possible solutions, we want to trigger the realization that improvements are possible and that these levers can yield economic benefits as well as health improvements.”

Harvey Fineberg, president of the Institute of Medicine added, “It’s very important for all stakeholders concerned with this problem to be able to tackle particular parts without losing sight of the whole – and to not be discouraged by the complexity. They should target particular solutions that are appropriate for their respective countries and settings, and work on those to drive improvements and long-term success.”

The IMS Institute for Healthcare Informatics provides key policy setters and decision makers in the global health sector with unique and transformational insights into healthcare dynamics derived from granular analysis of information. It is a research-driven entity with a worldwide reach that collaborates with external healthcare experts from across academia and the public and private sectors to objectively apply IMS’s proprietary global information and analytical assets.