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Medication adherence and insurance costs

Medication non-adherence can contribute to avoidable complications, unused prescriptions, and preventable costs. For insurers, the opportunity is to support patients earlier without turning adherence into surveillance.

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A CHF 250m target with further savings to unlock

Helsana estimates CHF 76m in 2024 savings against a CHF 250m annual target. The report points to further potential from generics and biosimilars, while noting that some measures may take effect over the following years.

See routine risk sooner

Adherence data can give care teams an earlier view of routine risk—an Adherlo workflow opportunity, not a measured outcome from the Helsana report.

Focus support where it counts

Exception-based workflows can help teams focus support where medication routines appear inconsistent.

Turn adherence into action

Clearer medication routines may create better moments for refill, substitution, and care discussions.

2024 savings position

Annual target

CHF 250m

70%

CHF 174m of the target remains

Estimated savings in 2024

CHF 76m

Remaining gap

CHF 174m

Additional substitution potential

CHF 65m

Helsana figures describe Swiss medication-cost and substitution context. They are not measured Adherlo outcome data or projected Adherlo savings.

Frame adherence as prevention support

For chronic conditions, medication only delivers intended value when it is taken consistently enough to support the care plan. Insurers can treat adherence as a prevention and support problem, not only as a cost-control metric.

  • Focus on helping members stay with appropriate therapy.
  • Connect adherence support to chronic-care and prevention programs.
  • Avoid claims that a single tool directly reduces costs without measured evidence.

Use Swiss cost context carefully

Swiss medication spending, deductible structures, reimbursement rules, and digital-health reimbursement context matter when discussing adherence economics. These references should frame the problem without implying guaranteed savings.

  • Separate system-level cost context from Adherlo-specific outcome claims.
  • Make affordability and reimbursement constraints visible.
  • Use evidence sources to explain why adherence matters, not to overstate commercial results.

Support before costs rise

Adherence signals can help identify members who may need education, refill support, routine adjustment, or care-team follow-up before the issue becomes more serious.

  • Use aggregated patterns to find where support programs are needed.
  • Keep individual interventions supportive and transparent.
  • Pair digital reminders with human follow-up where risk is higher.

Keep trust and privacy central

Insurance programs should be transparent about data use and focus on support, not punishment. Without trust, even well-designed adherence programs can fail to engage the people they are meant to help.

  • Explain what data is collected and why.
  • Use consent-based sharing for member-level visibility.
  • Avoid incentives or messaging that make patients feel monitored instead of supported.

The strongest payer adherence programs are built around patient trust first.

Measure population patterns responsibly

Population-level adherence trends can help insurers identify where education, device support, or targeted programs may reduce avoidable risk. They should be measured with clear baselines and reviewed against real outcomes over time.

  • Define the target population and baseline before launch.
  • Track engagement, adherence signals, and follow-up actions separately.
  • Review impact with clinical, privacy, and member-experience stakeholders.

Sources used in this guide

These references provide context for medication safety, adherence workflows, and the healthcare settings discussed here. They are not Adherlo outcome claims.

Switzerland · authority · 2025

Helsana Arzneimittelreport 2025

Swiss medication-cost and dispensing context. The report does not measure Adherlo outcomes or establish that reminders reduce costs.

Open source

Switzerland · authority

Swiss compulsory health insurance cost sharing

Official Swiss cost-sharing context for affordability discussions; it is not evidence that a specific adherence product reduces insurance spending.

Open source

Switzerland · authority

Mittel- und Gegenständeliste (MiGeL)

Official Swiss reimbursement context for means and devices. Inclusion does not imply that Adherlo is reimbursed.

Open source

Global · authority · 2017

WHO Medication Without Harm

Global medication-safety context for preventable harm and safer systems; not an Adherlo outcome claim.

Open source

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