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1. Most wasteful: Mississippi

Mississippi, which has the lowest median household income in the country, had the highest amount of per capita pharmacy-related waste last year, totaling $1,623 per resident.
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2. Most wasteful: Louisiana ($1,601)

According to the research, the most wasteful one-third of states spent between $1,404.82 and $1,622.76 per capita in avoidable costs. States with high levels of waste were found to be primarily located in the southern region of the country – an area also associated with higher rates of chronic disease.
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3. Most wasteful: Arkansas ($1,434)

Contributing to the wasteful spending, $55.8 billion was spent unnecessarily on higher-priced medications when more affordable, clinically equivalent alternatives were available.
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4. Most wasteful: Alabama ($1,489)

An additional $269.4 billion was spent on avoidable medical and pharmacy expenses from patients not maintaining their adherence to medication treatments. This total does not include the $59.6 billion in adherence savings directly associated with better pharmacy choices.
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9 out of the 10 poorest states rank among most wasteful


The other low-income states that top the list in unnecessary pharmacy-related costs include Kentucky, Tennessee, South Carolina, New Mexico and Oklahoma.


“Our nation pays a huge price for bad medication-related decisions, and it is clear that the price is even more costly for those at the lowest end of the economic spectrum,” said Steve Miller, MD, chief medical officer at Express Scripts. “The good news is that our country can save billions of dollars for patients, employers and the government – and achieve healthier outcomes – simply by driving better decisions within the pharmacy benefit.”
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Most frugal states

At the other end of the spectrum, states with the lowest levels of avoidable costs were predominantly in the Midwest and Northeast. According to research, $93.1 billion could have been saved if patients would have used the most cost-effective and clinically appropriate pharmacies, including home delivery and specialty. This savings includes $33.5 billion in lower drug costs, as well as $59.6 billion in avoided medical costs attributed to the higher adherence rates associated with home delivery and specialty pharmacies.
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Most frugal state: Vermont

Vermont wasted the least amount per capita among all states in the U.S., yet still experienced an average of $1,004.39 in unnecessary costs per resident. This map shows where each state ranks according to the Express Scripts research.
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