Polypharmacy and its impact on members and employers

2023 Q3 Rx Newsletter

August 22, 2023

What is Polypharmacy?

Polypharmacy is when a pharmacy utilizer is taking five or more medications at one time, which can increase the risk of adverse medical outcomes.1

How can Polypharmacy occur?

While it may sound like a rare occurrence, polypharmacy is actually very common. It occurs frequently with seniors or those who suffer from multiple health complications. It is so common that 1 in 5 Americans ages 40-79 use five or more prescription drugs.2 Although each medication has its benefit, it can become an issue for the patient and doctors who have to keep track of them all and be aware of the drug interactions.

Here are some of the reasons as to why polypharmacy may occur:3

  • Prescribing cascades: This refers to a patient who has multiple health conditions and is prescribed a medication to address the side effects of another medication.
  • Disconnected medical care: A patient may have multiple healthcare providers with whom they only interact with at certain points in the year. Prescriptions may have multiple refills and interact with newly prescribed medications, and a prescriber may not be aware of this until seeing the patient many months later.
  • Pharmacy changes: Patients may change pharmacies multiple times throughout the year and have different medications at each. Because of this, it is difficult for pharmacists to flag medications that may interact with one another.

What can be done to prevent Polypharmacy?

Polypharmacy can be managed, but it requires a team effort between patients, providers, and insurance partners. This is important as polypharmacy not only contributes to patient safety concerns but also financially to the member and insurer.

What you can do as a patient:3

  • Pick a point person: Work with a trusted primary care provider that can help keep track of and review drug utilization. Be honest and open with them about any new medications you are trying or previous medications that you have stopped taking that still have active refills.
  • Keep track of medications: Log all your current medications and supplements and bring it to your health care providers for review. It is important to make sure that these drugs are not duplicates of one another or interact negatively.
  • Talk to your local pharmacist: Pharmacists are always available to consult with when picking up your medication. They can also perform a drug utilization review on site and confirm that this medication does not interact with any others.
  • Don’t stop your medications without approval from your health care provider.3 It is easy to become overwhelmed when researching drug interactions, but it is important to stay on your medications until your doctor can provide a formal review.

As an employer, talk to your Pharmacy Benefit Manager (PBM) and inquire about programs that can help address polypharmacy concerns. More often than not, they will have a polypharmacy program that can help identify and consolidate these medications on behalf of members while saving money for employers.

 

 

Sources:
  1. “Polypharmacy: Evaluating Risks and Deprescribing,” American Family Physician, accessed July 27, 2023, https://www.aafp.org/pubs/afp/issues/2019/0701/p32.html
  2. “Prescription Drug Use Among Adults Aged 40–79 in the United States and Canada,” Centers for Disease Control and Prevention, accessed July 27, 2023, https://www.cdc.gov/nchs/products/databriefs/db347.htm#:~:text=Nearly%207%20in%2010%20adults,and%2018.8%25%20in%20Canada).
  3. “Polypharmacy Concerns and Risks,” Verywell Health, accessed July 27, 2023, https://www.verywellhealth.com/what-is-polypharmacy-2223450