Improving patient compliance	August 2007

Industry must connect with patients with immediacy and at a human level to improve compliance, according to panelists at Med Ad News and Guideline’s latest Trend Report breakfast meeting.

by Steven Niles

The issue of compliance and its impact on patient health is emerging as a major concern for the pharmaceutical community. The results of a survey on this issue were explored June 27 at the breakfast and panel discussion meeting, “Patient Compliance: Is There a Solution?” The event was sponsored by Guideline Inc. and Med Ad News magazine, the partnership behind The Trend Report, a regular supplement to Med Ad News available to all subscribers.

Guideline (guideline.com) conducted an online survey of more than 1,000 U.S. adults to study the extent of non-compliance, attitudes about taking medication, and possible approaches to aid compliance. To supplement the consumer viewpoint, Guideline also interviewed 100 primary-care physicians, including general practice, family practice, and internal medicine.

Report author Morris S. Whitcup, Ph.D., disclosed the report findings to an audience of industry professionals. A panel discussion followed, in which Dr. Whitcup was joined by Alfred O’Neill, senior VP, group director, Ryan TrueHealth (ryantruehealth.com), and Michael J. Evanisko, chairman, Adheris Inc. (adheris.com), to discuss issues raised by the survey results.

The panelists agreed that no one complete solution exists for solving patient compliance. Rather, the solution requires an integrated strategy incorporating physicians, pharmacists, advocacy groups, and the pharmaceutical industry working together to find ways to connect with patients with immediacy and at a human level.

Immediacy is vital. Compliance messages must reach patients within the first month of taking a new drug in order to ensure the first prescription renewal takes place. In addition, initiation of therapy tends to be the weakest point in the chain, according to Mr. O’Neill. From there, the information needs of patients change over the course of therapy, so communication must be continual.

Mr. O’Neill recommends identifying true believers — patients with success stories who can serve as advocates to other patients. He notes that when patients get frustrated with a particular course of therapy, someone must be available when they look for help. If no one is there, that is when patients become non-compliant.

Companies must be proactive in seeking out patients as well. Mr. Evanisko notes that opt-in style programs tend to miss an important segment of people. Those who seek information and opt into programs are likely compliant by nature. Delivering information to the other, non-compliant segment of the population is where the need exists.

Women are a largely unrecognized segment of the non-compliant population. Guideline’s survey found that very few physicians indicate that women are more apt to be non-compliant than men. Yet, the rate of non-compliance for women is slightly higher than that of men, and mothers readily admit that they are less careful about their own medications than men.

Dr. Whitcup believes that because women tend to be the caretakers in a family, they often take better care of their families than they do of themselves.

According to Mr. O’Neill, women tend to be the primary brand advocates. He believes that the same can be true in pharmaceuticals. He envisions a community solution in which patient populations are able to communicate within their group to drive the compliance message.

Mr. O’Neill cautions that the patient testimonial format may be played out in terms of its effectiveness. An information resource must be human and approachable and connect with a patient on an emotional level. He points to the arthritis drug Enbrel (enbrel.com) as having a good program that humanizes barriers and frustrations. The drug is marketed by Wyeth (wyeth.com) and Amgen Inc. (amgen.com).

In general, developing best practices based on the compliance programs already in place is difficult, according to Mr. Evanisko. Many companies’ compliance programs are so new that any that have found an edge keep a tight lid on their proprietary strategy.

Companies will need to experiment with various approaches to find ways to best communicate with patients on a level they can understand and trust. Ultimately, improved compliance rates will not only improve the industry’s bottom line but, more importantly, improve the public health.