Study Finds Many New Prescriptions Go Unfilled

Potential health benefits are not being realized because more than a quarter of new prescriptions are never filled.

Boston, MA, March 14, 2010 --( Potential health benefits from prescription medications can not be realized if patients fail to fill their prescriptions. Researchers at Brigham and Women’s Hospital (BWH) have evaluated this public health concern, discovering that more than a quarter of new prescriptions are never filled. These findings appeared online February 6, 2010 in the Journal of General Internal Medicine.

There has long been concern regarding the lack of adherence to prescribed medications. “Previous studies of medication adherence found that many patients stop taking medications soon after filling the first prescription,” said Michael Fischer, MD, of the Division of Pharmacoepidemiology and Pharmacoeconomics at BWH. “However, this is one of the first studies to investigate how often newly prescribed medications are not filled.” A major deterrent to studying primary non-adherence (not filling a new prescription) has been the inability to track written prescriptions before the first fill, but with increasing use of electronic prescribing technology, tracking adherence becomes more feasible. To address the lack of understanding of primary non-adherence, Dr. Fischer and his colleagues quantified the scope of the problem and identified predictors of non-adherence.

The study included 75,589 patients treated by 1,217 prescribers in the first year of a community-based e-prescribing initiative. The researchers compiled all e-prescriptions written over a 12-month period and used pharmacy filled claims to determine if prescriptions were filled. They calculated adherence rates for all e-prescriptions and for new medication starts and compared the rates across patient and medication characteristics.

Researchers found that 22 percent of all e-prescriptions were never filled, with 28 percent of newly prescribed medications never being filled. The study also demonstrated that primary adherence rates were higher for prescriptions written by primary care specialists, especially pediatricians, and prescriptions for patients aged 18 and younger were filled at the highest rate. Medication class was the strongest predictor of adherence, and non-adherence was common for newly-prescribed medications treating chronic conditions such as hypertension, hyperlipidemia, and diabetes.

“The high rate of non-adherence to medications for these serious chronic conditions is particularly concerning because, if left untreated, these conditions can contribute to risk for cardiovascular disease and other life-threatening conditions,” said Dr. Fischer. Accounting for this observation, Dr. Fischer and colleagues believe interventions that target specific medication classes may be most effective in increasing adherence to prescription medications.

The study was funded by a grant from the American for Healthcare Research and Quality.

About Brigham and Women's Hospital:-
Brigham and Women's Hospital (BWH) is a 777-bed nonprofit teaching affiliate of Harvard Medical School and a founding member of Partners HealthCare, an integrated health care delivery network. In July of 2008, the hospital opened the Carl J. and Ruth Shapiro Cardiovascular Center, the most advanced center of its kind. BWH is committed to excellence in patient care with expertise in virtually every specialty of medicine and surgery. The BWH medical preeminence dates back to 1832, and today that rich history in clinical care is coupled with its national leadership in quality improvement and patient safety initiatives and its dedication to educating and training the next generation of health care professionals. Through investigation and discovery conducted at its Biomedical Research Institute (BRI), BWH is an international leader in basic, clinical and translational research on human diseases, involving more than 860 physician-investigators and renowned biomedical scientists and faculty supported by more than $416 M in funding. BWH is also home to major landmark epidemiologic population studies, including the Nurses' and Physicians' Health Studies and the Women's Health Initiative. For more information about BWH, please visit

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