Medication adherence refers to how closely patients take their medications as prescribed. Nonadherence – which may involve failing to initiate treatment, taking incorrect doses, or discontinuing treatment – is associated with poor outcomes and higher healthcare costs.
Beyond the primary goal of enabling healthier and longer lives for patients, medication adherence directly impacts pharmaceutical manufacturers’ bottom lines. Understanding the factors contributing to adherence and using meaningful interventions based on data analytics will enable a brand's full potential to be realized.
Medication nonadherence is a long-standing problem that has been linked to poor health outcomes, increased hospitalizations, and higher costs of care. Consider the following findings:
Failure to adhere to prescribed therapy is an issue across almost all chronic conditions, including serious illnesses such as oncology, HIV, organ transplants, and glaucoma.
Even with good insurance and drug coverage, medication adherence rates for chronic conditions are between 50-60%.
50-70 are filled by the pharmacy
48-66 are picked up from the pharmacy
25-30 are taken properly
15-20 are refilled as prescribed
Good medication adherence is linked to a 21% reduction in long-term mortality and poor adherence with a 17% higher risk of hospitalization.
Nonadherence to prescribed treatment causes an estimated 125,000 avoidable deaths and $100 billion in preventable healthcare costs each year.
The issue is so prevalent that the American Medical Association (AMA) advises physicians to “consider medication nonadherence first as a reason a patient's condition is not under control.”
Disease-related complications that arise due to drug nonadherence come at a high cost to all stakeholders in the healthcare ecosystem. Pharmaceutical companies have long known that revenue suffers when prescriptions are never filled, or medications are not taken often enough.
A 2012 study estimated that the pharmaceutical industry loses $188 billion in actual and potential revenue each year due to nonadherence in the U.S. alone. That same study concluded that addressing medication adherence should be a top priority for pharmaceutical companies, particularly with the growing emphasis on value-based healthcare. Increasing adherence rates by just ten percentage points translates to $41 billion in revenue opportunity for manufacturers in the U.S. Clearly, investing in medication adherence strategies promises the dual benefits of driving more revenue while positively impacting health outcomes and costs.
A review of 79 studies on prescription nonfulfillment concluded that the primary reasons given by patients were concerns about medications – such as side effects or taking too many different drugs, lack of perceived need for the medication, and affordability issues. However, the root causes of medication nonadherence are quite complex, multifactorial, and challenging to pinpoint.
An in-depth analysis by McKinsey & Company determined there are four dimensions of variables that drive adherence:
Social, economic, and patient-related, including nonbehavioral factors, such as social determinants of health, and behavioral patient factors, such as social activity levels
Condition related, such as disease experience and comorbidities
Drug-related, such as experience with a drug and co-prescriptions
Health system-related, including provider’s disease experience, payer type, copay amount, and pharmacy type
Failure to stick with prescribed therapy is a substantial obstacle to realizing the inherent value of pharmaceutical innovation. Consequently, manufacturers must recognize the factors that impede medication adherence.
When pursuing medication adherence initiatives, pharma companies should be tracking real-world data on adherence rates, clinical outcomes, revenue, cost savings, and patient experience. They can then leverage data analytics to identify patients at high risk of nonadherence and employ proactive interventions that drive medication adherence. Examples include:
Sending out personalized refill reminders via text messaging
Disseminating educational materials on proper drug administration, dosing, storage, clinical safety, and efficacy and facilitating communication with an easy-to-use patient portal
Monitoring and promoting medication adherence and facilitating communications through a patient-friendly mobile application
Alerting nurse navigators to reach out to patients who are at risk of non-compliance through digital notifications
Facilitating and tracking benefits verifications, prior authorizations, enrollments in financial assistance programs, and copays with workflow tools
Beyond its commercial value, medication adherence is linked to better disease control and improved patient outcomes. A 2003 report by the World Health Organization (WHO) noted that “increasing the effectiveness of adherence interventions may have a far greater impact on the health of the population than any improvement in specific medical treatments.” Ultimately, drug manufacturers’ efforts to improve adherence will positively impact patient health outcomes and generate substantial clinical and financial rewards.
Phil provides an integrated approach to data analytics across the patient journey that provides manufacturers with real-time visibility into their distribution channels and supports efforts to drive medication adherence. Learn more about how Phil partners with manufacturers to facilitate patient access.
Our consultants will work with you to analyze your current channel strategy and make recommendations for how to improve patient access and increase the percentage of scripts getting covered by insurance.