Patient adherence to medicine is the eternal puzzle for big Pharma: what combinations of financial incentives, personalized interventions, and just good information work best to push down that stubborn 50 per cent abandonment threshold after six months of treatment? Certainly there are plenty of new programs on the market, so Pharm Exec believes it’s time to give some expert observers the chance to examine the “state of the art.” What follows is one of several guest blogs geared to helping readers assess the current and future state of medication adherence, in advance of our sister company CBI’s 12th Annual Patient Adherence and Support Summit and Industry Strategic Patient Adherence (SPA) Awards program, scheduled for April 29-30, 2013 in Philadelphia. Mark it on your calendars. This post is from Robert Nauman, Principal, BioPharma Advisors. Rob has been a chairperson and frequent presenter at the CBI conference. His post is a reflection of his 12 years of experience in managing industry-based medication adherence programs, in which he compares and contrasts early initiatives with current programs. — William Looney, editor in chief
As you look over the last 12 years of CBI conferences, a phrase relevant to this business issue comes to mind: “If at first you do not succeed, try, try again.” For those of us engaged in this work, we know the challenges, results and skepticism from more than a decade of experience. How do we ensure adequate funding and measurement of programs, to prove that program ROI is possible? To do this requires support of senior leadership from your company or your client.
In 1984, I developed a patient adherence program with a chain drug store, to demonstrate the ROI. We tracked the impact this program had on prescription refill lift. The 6-month pilot showed a 2 to 1 ROI, in terms of test versus control. However, our senior leadership did not support a larger program implementation, as the pharmacist at the store level was difficult to engage. This is changing with recent initiatives, where scripts used by pharmacists, at first fills, are resulting in 38%+ refill persistence over 6-12 months. Additionally, many chain drug stores have developed smart phone apps that automate adherence reminders and simplify prescription refill, with a 5 to 1 ROI. So, guided interactions and technologies may to help solve this industry problem at very little additional cost.
There continues to be broad acceptance that medication adherence is a problem and that the industry stands to benefit the most from its implementation. What is most needed is the continuous presence of adherence in the brand strategic plan. We believe that, along with senior level commitment, this is the primary barrier to resolving the problem. Why? Without a plan based on evidence for what works, vendor tactics drive brand strategy in this area. And, without experience with this planning, skill sets will not develop and be rewarded. One top 5 pharma company has had 4-5 task forces/leaders of medication adherence in this past 12 year time frame, without changes in corporate policies and procedures to integrate and institutionalize programming to ensure revenue generation. Perhaps this is one reason that some companies are looking outward, to a value based contracting model, to help solve the adherence challenge. So, there is innovation and determination, but without the commitment of senior management, this issue cannot be solved.
The April 2013 CBI Patient Adherence and Support Summit (PASS), and the Strategic Patient Adherence (SPA) Awards, will highlight companies and initiatives where corporate and brand strategies have provided the ROI needed to make patient adherence an integral part of business. I hope to see you at the conference this month.