Why pharmacy navigation is critical for better medication adherence.

It’s no secret that medication adherence is an important factor in achieving better health outcomes. However, nearly half of patients don’t take their medications as directed. This non-adherence can happen for many reasons—maybe the cost is too high, the instructions are confusing, or they’re dealing with side effects. Whatever the reason, the consequences are serious. Nonadherence can account for up to 50% of treatment failures, around 125,000 deaths, and up to 25% of hospitalizations each year in the United States. For employers, this means higher costs and reduced workplace productivity.

Traditional pharmacy benefits managers often overlook the importance of personalized support when it comes to helping members manage their medications. Pharmacy navigation bridges the non-adherence gap, offering members personalized guidance, education, and support to simplify the medication experience. It’s becoming clear that pharmacy navigation isn’t just a bonus feature—it’s an essential service every PBM should include to truly impact adherence to drive better outcomes.

How pharmacy navigation makes a difference in adherence.

Pharmacy navigation helps members overcome the hurdles that lead to non-adherence. Here’s how Rightway’s effective medication adherence management strategy works:

• Tailored support: At Rightway, members have direct access to an experienced, high-touch pharmacy care team made up of pharmacists and pharmacy technicians who provide personalized support and drive members to low-cost, high-value medications. They take the time to understand each member’s unique needs, answer their questions, and explain why it’s crucial to stick with their medication plan. This one-on-one approach helps members feel more in control of their health and how to overcome any challenges they face with their prescriptions.
• Clear cost information: High drug costs are a major reason people don’t take their medications as prescribed. In fact, 37% of patients say they have skipped filling a prescription and 12% say they have cut pills in half or skipped a dose due to cost. Traditional PBMs often hide drug prices, leaving members shocked by high bills when they get to the pharmacy. Rightway members can search for the price of any medication across network retail and mail-order pharmacies without requiring a prescription. If a cheaper, clinically appropriate alternative is available, Rightway will recommend it. When the financial burden is reduced, members are more likely to stay on track with their medications.
• Simplified medication management: For members managing multiple medications, it can be overwhelming to keep track of everything. Rightway makes it easier, helping members view current and past prescriptions, set medication reminders, track prior authorizations, and access pricing and drug details. With these tools, members can streamline their medication management and stay on track with their treatment plans.
• Proactive engagement: Rightway doesn’t just wait for members to ask questions about their prescriptions—pharmacy care teams take a proactive approach. They reach out to non-adherent members, especially those managing conditions like hypertension, high cholesterol, HIV, mental health, and asthma. Our robust clinical rule engine allows us to actively engage with high-risk members to ensure they stay on track and adhere to their medication plans.

Rightway has reimagined the role of PBMs in healthcare by integrating high-touch pharmacy navigation into the pharmacy benefits experience. Pharmacy benefits shouldn’t be a transactional, one-size-fits-all approach—they should be deeply personalized to ensure the best health outcomes for every individual. For benefits leaders focused on improving their team’s health and cutting unnecessary costs, partnering with a PBM that improves medication adherence is crucial. Get in touch with our team to learn more.