Once we understand what the FICO Medication Adherence Score is, and why insurers, pharmaceutical companies and employers will pay for and use that score, then we can draw conclusions about how it will affect patients and what we can do to attain and maintain the highest score possible.
Potential Benefits to Patients of the FICO Medication Adherence Score
- One positive outcome might be that we patients will begin to ask more questions and participate in decision-making with our doctors before we agree to accept a prescription. Once that happens, our individual adherence rates may actually go up, meaning our scores will, too.
- Conversely, if we don't take a drug prescription according to its directions (maybe skipping doses or taking too much of it, as pain patients sometimes do), then knowing that our medication adherence scores will reflect the violations may compel us to discuss dosing variations with our doctors.
Problems for Patients that Result from the FICO Medication Adherence Score
By developing an algorithm that determines patient adherence as a function of whether patients purchase a drug that is prescribed and purchase refills at the right times, FICO seems to have redefined what "adherence" means. By FICO's definition, the traditional measurements of whether a patient fills - and TAKES - the prescription according to directions seems to have gone by the wayside. FICO believes it is only the actual purchase that is important.But there are reasons patients don't purchase the drugs they are prescribed. Granted, sometimes they just don't make the effort. But sometimes cost can be a major barrier to purchasing a drug prescription, which is truly no reflection on how adherent a patient is about taking his or her medication.
Further, unlike a credit score that we do have some control over and that is based only on our borrowing and debt-repayment records, too often we have little or no control over those medical problems that take us to the doctor and generate prescriptions. Many illnesses and conditions arise through no fault of our own. And we are never prepared for large medical expenses. Unfortunately, there is no accounting in this FICO score for unexpected diagnoses or financial difficulties and their effect on prescription drug affordability.
We can presume FICO will peddle its scoring system to insurers to help them price insurance for an individual. Even thought insurers cannot simply deny coverage to an individual with a pre-existing condition, they can price it so high that they know the individual will turn them down. The FICO score may also indicate to an insurer whether or not we have been truthful on their application. When paired with our Medical Information Bureau information, insurance companies will know almost everything there is to know about us that affects their bottom line.
Employers may have many uses for such a score. It may help them decide whether to hire you or lay you off before they lay off someone else with a higher score, or support your efforts at improving your score if you are among their most valued employees.
How Can Patients Build and Maintain High FICO Medication Adherence Scores?
Just as we work hard to keep our FICO credit scores as high as possible, there are steps we can take to raise and keep higher FICO medication adherence scores as high as possible.The only way you will be able to make sure your score is as high as possible will be to purchase your medications in exactly the right time in which they are prescribed, and possibly to control how you make other purchases that may be included in the FICO algorithm. Here are some approaches for making this work:
- Instead of accepting a prescription just because you always have, you'll want to discuss its necessity and use with your doctor. Ask what the drug is, why you should take it, how much of it you should take and what to expect when you do. Just as important, push back if you don't think you will fill the prescription or think you may take it differently from the way it was prescribed. Remember, any variation in the doctor's intent and your real use will reflect negatively on your FICO score.
- If you are confident the medication was prescribed for all the right reasons, then be vigilant about taking it the way you have been instructed, and order refills in the right time frame. If you lack confidence in its necessity, read the paragraph above.
- Be sure to fill all prescriptions your doctor does write, even if you don't intend to take them. That said, if you don't intend to take them, read the paragraph above that begins with "Instead of accepting a prescription...."
- If you can't afford the drug, then have that conversation with your doctor and look at other ways you may be able to purchase your drugs less expensively. If there is no alternative, you may want to decide not to accept a prescription you will not take because your FICO score will be dunned for non-adherence. That's a sad and wrong-minded response, but we patients have to protect ourselves if conclusions about us are drawn that are unfair and we know that non-FICO-defined-adherence will be more costly to us in the long-run.
- If you can afford it, then purchase the drug, even if you don't take it the way you are expected to, then be sure to order your refills on the right schedule. For health purposes, you are expected to take the drug exactly as prescribed. But FICO will have no idea if you are actually taking the drug or if you are using it up too quickly. They will only know, and score you, based on the schedules the doctor determined, compared to when you actually make the purchases.
- Finally, if you want to go against your doctors' orders and buy foods or beverages, cigarettes or any other substance that may be detrimental to your health and that you've been told to avoid, pay for them in cash. Also, if you want to make a purchase of any of those products for someone else pay for them in cash, too. Do not use your credit card or an affinity card (those cards you swipe at the supermarket or pharmacy check-out for discounts) when you purchase them. FICO sees everything associated with a card, but they have no idea what you pay cash for. Note: This is not a recommendation that you should make these purchases. It's only a way to improve your FICO adherence score.
What Will We See in the Future with FICO Medication Adherence Scores?
Patients and doctors will be caught in the crosshairs.First, the score will totally change our relationships with our doctors regarding how they write prescriptions for us. We will have to be more assertive with our doctors in order to encourage them to engage in the more extended conversations we need about the drugs they want to prescribe for us, before they prescribe them. It will force us to be far more participatory in the decision-making about prescriptions.
There will come a time when some patients are being so negatively affected by these FICO medication adherence scores they will need to be able to access their scores to double check their accuracy. Just like having a procedure in place to check our financial credit scores, our medical records and our Medical Information Bureau records, we will need a way to see how our FICO scores were obtained and how to correct them. But that will take years, and probably a few lawsuits, before such a process is in place.
