Using Claims Data as a Proxy for Medication Adherence

Effective treatment of HIV is dependent on patient’s medication adherence. In  managed care plans pharmacy claims data can be used as a proxy for medication adherence.   Prescription fill dates and dosage can be used by the Plan to calculate the number of days the Member has medication. 

Plans serving the HIV population can use pharmacy claims data to monitor medication adherence. Medication possession ratio (MPR) and proportion of days covered (PDC) are the most common measures of medication adherence based on patient refill records.

“Do You Know the Difference Between These Adherence Measures?” Pharmacy Times, 6 July 2015

https://www.pharmacytimes.com/view/do-you-know-the-difference-between-these-adherence-measures

Sikka, R., Xia, F., & Aubert, R. E. (2005). Estimating medication persistency using administrative claims data. Am J Manag Care11(7), 449-457.

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