Medication Adherence Lowers Cost, ER Visits Among Patients with CVD

Better medication adherence in patients with cardiovascular disease (CVD) saves money and keeps them out of the emergency department, according to a study in the Journal of the American Pharmacists Association.¹ With pharmacists’ expertise lying in medication use, they are primed to facilitate prescription drug regimens for patients with CVD.

“Tailored pharmacy-based interventions address barriers to medication adherence by examining the factors that affect a person's ability to take their medications,” writes the CDC.² “These barriers may be complex and include factors related to socioeconomics, health care system structures and processes, severity of co-occurring medical conditions, complexity of medication and nonmedication therapies, and patient concerns.”

For decades, the 80% medication adherence threshold has been regarded as the “holy grail” of clinical outcomes research. However, the current study suggests that for patients with CVD, merely hitting this mark may not be enough to capture maximum cost savings.¹

The research, which tracked over 200,000 patients, reveals that pushing adherence beyond the traditional 80% target—specifically to 90% or higher—is associated with a significantly lower total costofcare. Conversely, even a minor slip in adherence for those previously at the top tier can trigger a financial and clinical tailspin, with total costs of care spiking between 9% and 31% when patients fall from “very high” to lower adherence rates.

READ MORE: Pharmacists Play Crucial Role in Managing Women’s Heart Health

The implications for pharmacists are profound, as the data shows that moving from between 80% and 90% adherence to above 90% resulted in 12% to 24% lower total costs across 4 critical medication classes: antidiabetics, direct oral anticoagulants (DOACs), antiplatelets, and anti-heart failure (HF) medications.¹

These findings arrive at a time when CVD remains a primary driver of healthcare spending, with the CDC noting that nonadherence is directly linked to higher rates of emergency department visits and hospital admissions. While the study found mixed results regarding the odds of cardiovascular-related emergency room visits, the overall trend suggests that improved adherence consistently mitigates the most expensive forms of medical utilization.^1,2

Pharmacists are uniquely positioned to bridge this adherence gap through tailored, pharmacy-based interventions that the CDC has identified as highly cost-effective.²

Strategies such as medication therapy management (MTM) and the appointment-based model allow pharmacists to manage chronic conditions proactively rather than passively filling prescriptions. By utilizing tools like medication synchronization, pharmacists can ensure all of a patient's medications are ready for a single monthly pick-up, reducing the complexity that often leads to missed doses.

Beyond administrative logistics, the human element of counseling remains vital.

Experts like Candis M. Morello, PharmD, APh, CDCES, FCSHP, FASHP, professor of clinical pharmacy at the Skaggs School of Pharmacy and Pharmaceutical Sciences at the University of California, San Diego,emphasize that many patients are overwhelmed by complex regimens, sometimes taking 12 or more medications daily.³

Successful pharmacists often employ visual aids, such as color-coded glucose zones or diagrams showing exactly which organs a medication targets to help patients see the tangible progress of their therapy. Furthermore, integrating “food as medicine” into these conversations—counseling on the dietary approaches to stop hypertension (DASH) or Mediterranean diets alongside statin therapy—can empower patients to take an active role in their heart health.^3,4

Despite these opportunities, global barriers persist. A nationwide study in Malaysia highlighted that while community pharmacists provide satisfactory counseling, many are hampered by a lack of access to medical records and a shortage of educational materials, according to PLoS One.⁵

These challenges underscore the need for more integrated healthcare systems where pharmacists can work under collaborative practice agreements (CPAs) to adjust medications and order labs in real-time. As healthcare shifts toward value-based models, the role of the pharmacist is evolving from a dispenser of pills to a central coordinator of cardiovascular health, among many other conditions and disease states.^2-4

Sustained, high-level adherence is a primary lever for reducing the economic burden of heart disease, and the pharmacist is the professional best equipped to pull it off.¹

“Among patients aged 50-80 years with a history of CVD who take antiplatelets, DOACs, antiHF medications, or GLP-1/SGLT antidiabetic medications, improving adherence beyond the traditional 80% target lowered the odds of cardiovascular-related emergency department visits for some and total cost of care for all,” concluded authors of the current study. “Among patients whose adherence decreased over 12 months, total cost of care increased.”

READ MORE: Cardiology Resource Center

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REFERENCES

1. Peasah SK, Lee T, Huang Y, et al. Healthcare utilization and costs associated with changes in medication adherence around the 80% threshold in patients with cardiovascular disease. JAPhA. March 25, 2026:103104. https://doi.org/10.1016/j.japh.2026.103104

2. Pharmacy-based interventions to improve medication adherence. CDC. May 15, 2024. Accessed April 16, 2026. https://www.cdc.gov/cardiovascular-resources/php/medication-adherence/index.html

3. How can pharmacists help patients improve medication adherence? National Institute of Diabetes and Digestive and Kidney Diseases. February 8, 2023. Accessed April 16, 2026. https://www.niddk.nih.gov/health-information/professionals/diabetes-discoveries-practice/pharmacists-help-patients-improve-medication-adherence

4. Smith M. The role of pharmacists in cardiovascular health: a collaborative approach to treatment, counseling, and nutrition. Pharmacy Times. June 11, 2025. Accessed April 16, 2026. https://www.pharmacytimes.com/view/the-role-of-pharmacists-in-cardiovascular-health-a-collaborative-approach-to-treatment-counseling-and-nutrition

5. Ismail FF, Md Redzuan A, Chong WW, et al. Role of community pharmacists in cardiovascular diseases-related health promotion and dyslipidemia management in Malaysia: a nationwide cross-sectional study. PLoS One. 2023 Sep 28;18(9):e0290883. doi: 10.1371/journal.pone.0290883.