Everyone is talking about Patient Adherence

OK. Maybe not everyone.

But certainly all of pharma! And then much of healthcare – payers, insurance companies, private medicine, even some doctors, although not all.

Notice what’s missing?

Patients! Patients aren’t talking about adherence!

So what is going on here? We all know big pharma is facing a very uncertain future. Lots of big – read profitable – products going off patent, and, of course, the rise in the use of generics, so where to go to continue to grow profits. Of course, everyone is looking to emerging markets, but even there it is becoming clear that the future is not as promising as it once appeared to be, with strong price pressures from governments, massive competition from within big pharma and a market that does not want to be dominated by big international players. So patient adherence is growing in importance.

It is incredibly important to pharma companies because they know that only around 50% of patients stay on therapy after 6 months. And if they can extend and grow the amount of time a patient continues to take their medication then their profits grow exponentially.

Even chronically ill patients often fail to adhere to treatment, but if pharma can convince each patient to stay on therapy, even if that means only filling a couple of extra prescriptions, then the benefit to the bottom line is substantial. But what does this mean for patient health?

If a patient requires medication to manage a chronic condition, and they need to stay on that therapy for the rest of their lives, then what good does another 1, 2 or 3 months worth of additional adherence do to enhance the patients long-term health? Probably not a lot.

Patient adherence is about improving patient health outcomes not merely adhering to taking a medication regime and while pharma is seen as driving adherence programs generally the intent behind adherence is for the primary benefit of patients.

And, of course, it is easy to point the finger at pharma. But really this is a bigger issue and one that is the responsibility of the healthcare eco system, including pharma. Pharma stands to gain financially by addressing this issue, but the benefits go far beyond pharma. This is a win win, but it is going to require that all the stakeholders work together to deliver better patient outcomes and do it without breaking the bank.

Patient Adherence is about patients. Sounds obvious, but the discussion is usually focused on the benefits to other stakeholders in the system. But, in the end, this is about delivering better patient outcomes. However, we need to be careful here, because these improved outcomes are probably not well aligned with the goals of pharma, even physicians in some cases, because better health outcomes are best defined and agreed directly with patients.

Let’s take an easy example. patient x is obese, and needs to lose weight. They may be prescribed medication and a regime of diet and exercise. We can learn something from the weight loss industry here: while BMI and other scientific orientated tools say they must lose for example 100lbs, the patient may have a different view. They would be very happy if they lost 50lbs. Weight loss program try to find a goal weight that the patient owns and signs on for (almost regardless of the science) and they work hand in hand with the patient to get them to goal.

Sounds like common sense. But getting the healthcare industry to work to patient orientated health goals is a significant challenge. And don’t even think about the legal implications.

The bottom line though is that it is critical to engage patients and care givers in agreeing realistic health goals and working as a team across healthcare to help patients achieve these goals.

Now that’s a patient adherence program I can agree to.

Oh, and by the way, the pharma industry will probably benefit as will the healthcare system as a whole.


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