Michigan's Health Alliance Plan (HAP) is the first health plan in Michigan to help consumers avoid overuse, underuse and misuse of medications, with a new program designed to help its 540,000 members and 3,000 employer groups avoid polypharmacy.

Polypharmacy is characterized by too high or too low dosages of medications, medications incorrectly prescribed or filled, prescribed medications that duplicate or interact with other prescriptions or herbal medications that interact with prescriptions.

HAP's new program, in conjunction with the Henry Ford Health System, lets clinical pharmacists review medical records of members taking five or more medications — a high risk situation for polypharmacy — and work with the patient's primary physician.

The polypharmacy program aims to improve patient safety and quality of care for HAP members.

"Polypharmacy is a growing health crisis in every community," Fadwa Gillanders, a HAP clinical pharmacist, said in a statement. "Evidence suggests that more medications are prescribed and taken than are clinically warranted. The elderly are at greatest risk of polypharmacy, as are those with multiple medical disorders, multiple physicians or a recent hospitalization.

"Patients go to multiple physicians and pharmacies. Doctors can't keep up with every new drug on the market. And consumers don't realize that herbal and homeopathic remedies may conflict with their prescriptions," Gillanders said. "We found we can reduce the risk by involving not only patients, but also health plans, pharmacists and caregivers."

The reviews revealed that polypharmacy is common, with many patients on high-risk, high-cost medication regimens such as Viagra with nitrates (a potentially fatal combination), multiple benzodiazepines to treat anxiety, and multiple narcotic prescriptions with other central nervous system depressants.

In addition to increasing patient safety, the Polypharmacy program also addresses reducing drug costs, with the program targeted to save the community, employers, members and HAP $500,000 in drug costs over three years, while helping patients avoid thousands of dollars in out-of-pocket drug costs.

Medication misadventures in the outpatient setting were estimated to have cost the U.S. $2 billion in 2000. The reduction of polypharmacy improves medication safety and lowers cost of drugs and ancillary services needed to manage adverse drug events.