Boosting medication adherence with a simple switch

Plan sponsors that integrate home delivery into their plan design can improve medication adherence and overall health outcomes.
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Chronic conditions are on the rise

The appearance and diagnosis of chronic conditions are on the rise. In the United States, 60% of adults have been diagnosed with at least one chronic condition. And within the over-50 population, specifically, the number of people with at least one chronic condition is expected to nearly double, hitting 142 million by 2050.

Related: Chronic conditions: The impact of delayed detection

Chronic diseases are long-lasting conditions that limit daily activities, require ongoing medical care or both.

Managing these conditions requires strict adherence to a prescribed treatment regimen.


Unfortunately, this can prove difficult for many people. Approximately 50% of medications for managing chronic conditions are not taken as prescribed, adding to the significant levels of nonadherence in this country.

Patients struggle with taking their medications as prescribed for many reasons, including being unable to afford them, unexpectedly running out, and having concerns about possible side effects. Often these can be rectified when a patient chooses to get their medications through a home delivery pharmacy

In fact, several studies over the years have demonstrated that patients using home delivery pharmacies have higher adherence rates compared to those using retail or community pharmacies. However, there has been little research on whether switching from filling a prescription at a retail or community pharmacy to filling via a home delivery pharmacy affects adherence and other health outcomes. Until now.

Reversing the adherence trend

The Evernorth Research Institute conducted proprietary research to analyze the association of pharmacy category between members who switched to home delivery from retail and those who remained at retail. We examined commercial beneficiaries between 18 and 64 years old.

We conducted a retrospective analysis of claims processed between July 1, 2020, and December 31, 2022, that included three discrete therapy classes — diabetes, high blood pressure, and high blood cholesterol. To estimate adherence, we measured proportion of days covered (PDC). PDC is the percentage of days that a patient has medication on hand. A patient with a PDC over 80% is considered to be adherent.

Making the switch can make all the difference

Our analysis uncovered a significant relationship between improved adherence rates and a patient moving their prescription from a retail or community pharmacy to a home delivery pharmacy solution. 

Patients who switched to getting their prescriptions from a home delivery pharmacy were observed to have two to three times greater odds of achieving our adherence benchmark.


We also saw they had fewer inpatient hospital stays and emergency room visits, demonstrating that moving medications to home delivery reduces higher cost medical visits, as well.

We found that patients with diabetes were 17.2% more adherent and those with high blood cholesterol were 16.1% more adherent after switching to a home delivery pharmacy. The research also found that patients with high blood pressure increased their adherence rate by 18.6%.

Click here and learn more about how integrating home delivery into your plan design can improve medication adherence and overall health outcomes.

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Express Scripts® Pharmacy
The first to deliver prescription medication straight to patients’ homes, Express Scripts® Pharmacy has been leading the way in making the pharmacy experience simpler and better. With easy-to-use digital tools, automatic refills, flexible payment options, and 24/7 pharmacist support, we’re delivering more than medication.