Prescription drugs are expensive, whether you pay for them in cash, have to dig deep to cover the donut hole, or have to pony up a co-pay even though you have insurance.
But someday it's possible that the real expense of prescription drugs will have little to do with the cost of their purchase, and everything to do with whether you actually fill the prescription, and purchase the refills on schedule.
Enter FICO - Fair Isaac COmpany - those diabolical business people who invented credit scores to help control whether we Americans can make credit purchases. Now they will tell you that they only cough up a number - that we individuals actually control our own credit scores because we control how well we borrow money and pay it back. I can buy that.
But now FICO has invented a new score - the FICO Medication Adherence Score. It will measure how well we fill and pay for our prescriptions - as if that is some accurate measurement of how adherent we patients are, and therefore how well we control our own health.
Seriously? That's one of the most ridiculous data uses I have ever heard of - and I am not alone. There are so many reasons patients don't fill prescriptions that don't relate to whether we think we should take them. They may be too expensive. We may have an allergic reaction and therefore do not fill subsequent refills. Or maybe there is a shortage - and just how much control does anyone thing we patients have over drug shortages?
Thing is - I have to give FICO some credit. When you read about all the organizations who will pay them for the information and what they will use it for, you'll have to agree with me that the idea is genius.
It's just that it's based on the wrong conclusions and assumptions! Garbage in, garbage out. And guess just who will end up paying for it in the long run? Of course. We patients.
Sometimes the best way to beat a ridiculous idea is to join it - or game it - or intentionally try to mess it up. So I've come up with some ways to do that. I invite you to take a look, to make smart decisions about affecting your FICO Medication Adherence Score that won't have a negative effect on your health, and to join me in doing our best to send FICO back to the drawing board.
• What Is the FICO Medication Adherence Score?
• How to Control Your FICO Medication Adherence Score
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Thanks for sharing this new disaster in the making. Doctors already have a CPT4 code that they can use to “Tag” patients who are “non compliant”. While they don’t get paid for the code it is a defensive tactic to protect against lawsuits, insurance denials and being poorly rated/paid by the insurance companies because they aren’t following the required treatment practices of the insurance company. “Non compliance” is a way to blame the patient.
This is just one more example of the systems intrusions (government and non government) into our personal lives. Remember that under the new healthcare program all of our medical records are now being sent to the government for a large comparative database. Ostensibly this is to “mine” the data for best practices. It will also be used to identify individuals who haven’t purchased insurance or don’t follow the “orders” of the doctor/insurance company/government.
Again thanks for bringing this to the public attention. Most don’t have a clue what is happening. Thanks for the short course in how to “work” the system so it hurts you the least.
I have always contended that there are no non compliant patients. Just those that didn’t have the courage to openly disagree with their doctor’s recommendations. Instead they passively don’t follow “orders” that they didn’t agree with to start with.
First, for anyone who hasn’t seen it, here’s last year’s e-patients.net discussion of this idiotic idea. (Not that I have an opinion about it, heh.) What subscribers (FICO’s customers!) need to realize is that it’s built on crap logic, which Trisha describes correctly here.
Seriously: everywhere in healthcare too many people seem to not comprehend that if you want data to be useful, it must CAREFULLY and THOUGHTFULLY represent REALITY, not just be a poorly-thought-out slapdash piles of bits collected simply because they were easy to grab. That method is like the drunk seeking his keys under a street lamp.
I take issue with just one point – “they will tell you that … we individuals actually control our own credit scores because we control how well we borrow money and pay it back. I can buy that.” Well, my score took a beating when I was sick. And I CANNOT GET THEM TO TELL ME WHAT SPECIFICALLY I NEED TO DO, TO GET IT BACK UP.
They’ll tell me (because they’re required to by regulators) that “there’s a problem back there” of various sorts, but they will NOT say exactly which – and even my credit union gets huffy when I push them to help figure it out. Worse – and more to the point – they will not tell me what I could do, specifically, to cause their secret formula to ratchet me up 5 or 10 or 30 points.
This is a “secret sauce” for-profit scheme, period, and it robs me of my ability to improve my situation. That’s “disempowering” if I ever saw it. It is not a level playing field.
And these bozos want to sell poorly-thought-out med “adherence” data to subscribers who don’t think? Yeah, indeed, if they’re not even watching, let’s game the system.
Even more fun would be if we find providers who’ll give us scripts and not record ‘em.
I *like* that idea.
What happened to patient privacy?
It won’t be easy to game the system here because they also include irrelevant data such as geographic location, the number of bankruptcies filed in the area, and mean income.
I live in a rural area where many people are living in poverty and jobs are disappearing, so the bankruptcy rate is climbing. Insurance coverage and access to medical care and prescription drugs are disappearing along with the jobs.
Even those who are well off and comply with “doctor’s orders” will have lower scores just because they live in the area–including doctors themselves.
Fair Issac’s medical scores are irrational. There’s just nothing “fair” about them.